Failure Mode, Effect, and Criticality Analysis of the Parenteral Nutrition Process in a Mother-Child Hospital: The AMELIORE Study

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
Marianne BouléJean-François Bussières

Abstract

The parenteral nutrition (PN) process is complex and involves multiple steps and substeps, especially in pediatrics and neonatology, given the particular needs of these patients. The objective of this study was to perform a critical analysis of the PN process at the Centre Hospitalier Universitaire Sainte-Justine to determine which potential pitfalls are related to this process and which should be prioritized when implementing corrective measures. This is a Failure Mode, Effect, and Criticality Analysis (FMECA) study. A multidisciplinary team assessed each step of the PN process and identified associated failure modes. Adapted rating scales were used to determine severity, frequency, and detectability of the failure modes. Ratings were established through multidisplinary consensus, and a criticality index (CI) was calculated for each failure mode. A total of 265 failure modes were identified in the 5 major steps of the PN process. The failure mode with the highest CI was the inscription of an inaccurate weight at prescription, with a CI of 800. The step with the highest cumulative CIs was administration to patients, with a CI sum of 7691. Various recommendations aimed at minimizing the risks associated with the PN process were ...Continue Reading

References

Feb 14, 2002·JPEN. Journal of Parenteral and Enteral Nutrition·UNKNOWN ASPEN Board of Directors and the Clinical Guidelines Task Force
Sep 10, 2002·JPEN. Journal of Parenteral and Enteral Nutrition·David A August
Mar 21, 2009·Clinica Chimica Acta; International Journal of Clinical Chemistry·Maria Laura Chiozza, Clemente Ponzetti
Nov 28, 2013·JPEN. Journal of Parenteral and Enteral Nutrition·Phil AyersUNKNOWN American Society for Parenteral and Enteral Nutrition
Jun 29, 2014·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Jose Javier Arenas VillafrancaVicente Faus Felipe
Jul 28, 2015·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Mark MacKayJeffery Zobell

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Citations

Dec 19, 2019·Journal of Evaluation in Clinical Practice·Hu-Chen LiuLiang Wang
Jun 8, 2021·Therapeutics and Clinical Risk Management·Isabelle SommerFarshid Sadeghipour

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