FMEA; Failure Mode Effects Analysis

Name of StudentInstitution

FMEA: Preparation of a 55-year old male for a prostate surgery

Introduction:

The initials FMEA stands for Failure Mode Effects Analysis, which is a step-by-step analysis that is used for identifying the potential failures in a process, or a product (Stamatis, 2003). The term “failure modes” stands for the means or ways in which a process, or the thing that is under analysis might fail. The failures can be potential or actual, and they refer to the effects or errors that affect the service user. On the other hand, the “effects analysis” refers to the study of the consequences of the errors identified. In relation to the procedures in health sciences, failure modes and effects analysis incorporates the study of the current knowledge, as well as, the knowledge being developed. This essay purposes to analyze the procedure of preparing a 55-year old male for prostate surgery using the FMEA tool. The procedure is first described using the high-level flow chart of events, then the errors ad failures associated with the steps are discussed in a tabular representation in line with the FMEA tool.

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1438275949325Ensure all investigations are done to determine the appropriateness and suitability of the surgery

Preparation of a 55-year male for prostate surgery:

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Teach the patient deep breathing exercises

Perform head to toe examination and take history

Give the prescribed medications to the patient

Verify that the client has given consent for the operation.

Explain the surgical procedure and its benefits and expected effects to the patient

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4467225107315714375406406877062540Encourage client to void and empty bladder

Verify identification by checking the identification badge

Orient client’s family to the hospital environment

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132397536195036766503714754838700-847726Encourage the family members to spend time with the client

Gently, transfer the patient to the stretcher

Place call bell within reach and encourage client to call in case of eventuality

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Complete the patient notes. Check that preoperative checklist is signed (Smeltzer et al., 2010)

Accompany the patient to the operating room with the notes (Williams &Wilkins, 2002)

Make sure blood is ready, in case of transfusion, and ensure the client has an infusion site ready

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48837857302569278515875Again assure the patient as you hand him over

FMEA of the process of preparing a 55-year old male for prostate surgery:

PROCESS

STEP POTENTIAL

FAILURE MODE POTENTIAL

EFFECT severity of effect Probability of failure

Detection of failure Criticality score

Explain the procedure to the patient (Williams &Wilkins, 2002) The nurse fails to explain procedure to patient Patient goes to theatre with fear and anxiety 3 2 3 70

Verify that the client has given consent for the operation.

The nurse fails to verify the patient’s consent Patient s operated without consent 5 3 1 90

Ensure all investigations are done

The nurse fails to ensure that investigations are done Patient may get complications intra- or post-operatively 5 4 1 80

Teach the patient deep breathing exercise (Smeltzer et al., 2010) The nurse fails to teach the patient breathing exercises Patient’s circulation is compromised while bedridden 4 4 3 60

Perform head to toe examination and take history

The nurse fails to examine the patient The patient gets complications 4 3 3 50

Give the prescribed medications to the patient

The nurse fails to give medication to the patient Patient experiences pain and other effects 3 3 2 50

Encourage client to void and empty bladder

The nurse fails to tell the patient to empty bladder The patient experiences a lot of pressure and pain 3 3 3 40

Verify identification by checking the identification badge

Nurse fails to verify patients identity A wrong patient may be operated 5 5 2 90

Orient client’s family to the hospital environment

The nurse fails to orient the family to the hospital environment The family is not able to provide adequate anxiety relief to the client 3 3 3 40

Place call bell within reach and encourage client to call in case of eventuality

Nurse forgets to place the bell within patient’s reach Patient experiences and emergency and is not able to call for help 4 4 3 60

Encourage the family members to stay with the client

The nurse fails to counsel the family members Family members are not able to provide adequate care to the client 3 3 2 40

Gently, transfer the patient to the stretcher

The nurse transfers the client roughly Client experiences pain 2 2 1 20

Complete the patient notes. Check that preoperative checklist is signed

The nurse fails to check the pre-operative check-list Client may experience complications because some variables may be compromised 4 4 1 60

Accompany the patient to the operating room with the notes

The nurse fails to carry the notes with her/himself No notes handed over to the operating team 4 4 1 50

Make sure blood is ready, in case of transfusion, and ensure the client has an infusion site ready

The nurse fails to order for blood before operation Patient complicates during surgery 5 4 1 90

Assure the patient while handing over The nurse fails to assure the patient Patient develops anxiety 3 3 3 30

Rating key:

Severity rating scale:

No effect 4. Significant/long-term effect

Minimal effect 5. Catastrophic effect

Moderate/short-term effect

Probability rating scale:

Highly unlikely/never happened before

Low/relatively few failures

Moderate/occasional failures

High/repeated failures

Very high/failure almost inevitable

Detection rating scale:

Almost certain to be detected

High likelihood of being detected and corrected

Moderate likelihood of being detected and corrected

Low likelihood of being detected and corrected

Remote likelihood of being detected and corrected

CRITICAL FAILURE ROOT CAUSES REDUCING FAILURE MEASURES OF SUCCESS

The nurse fails to explain procedure to patient Negligence The administration should take disciplinary action Rates of negligence on this step

The nurse fails to verify the patient’s consent Negligence Disciplinary action Percentage of the cases

The nurse fails to ensure that investigations are done Failure by the hospital to institute policy Hospital to emphasize on following procedure Percentages of investigations that are not done

The nurse fails to teach the patient breathing exercises Inadequacy of patient preparation knowledge Continuous education to reinforce knowledge Rates of cases in the theatre

The nurse fails to examine the patient negligence Stern disciplinary action Rates of cases

The nurse fails to give medication to the patient negligence Stern disciplinary action Rates of failure cases

The nurse fails to tell the patient to empty bladder Lack of knowledge on its importance Encourage nurses to keep learning new knowledge Percentage of failure cases

Nurse fails to verify patients identity negligence Stern disciplinary action Percentage rates of such cases

The nurse fails to orient the family to the hospital environment Inadequate knowledge on the issue Encourage continuous education Percentage rates of such cases

Nurse forgets to place the bell within patient’s reach Negligence Stern disciplinary action Rates of such cases

The nurse fails to counsel the family members Lack of emphasis on counselling family members Emphasize on the role of the family members in preoperative care Percentage rates of such cases

The nurse transfers the client roughly Negligence: patients should be handled with care Stern disciplinary action Percentage rates of such cases

The nurse fails to check the pre-operative check-list Negligence The nurse should be given a warning Percentage rates of such cases

The nurse fails to carry the notes with her/himself Negligence Give a warning to the nurse Percentage rates of such actions

The nurse fails to order for blood before operation Negligence Take a disciplinary action against the nurse Percentage rates of such cases

The nurse fails to assure the patient Lack of knowledge on the importance of allaying anxiety Encourage continuous medical education Percentage rates of such cases

Conclusion:

The above two tables and the high-level flow chart have been used to analyze the procedure of preparing a 55-year old male patient for prostate surgery. The FMEA tool has identified the errors that are likely, their potential effects, the consequences, the root causes, and, as well, the measures that can be taken to reduce the errors.

References

Smeltzer, C. S., Bare, B., Hinkle, L. J., & Cheever, H. K. (2010). Brunner and Suddarth’s textbook of medical-surgical nursing, volume 1. New York, NY: Lippincott Williams and Wilkins.

Stamatis, D. H. (2003). Failure Mode and Effects Analysis: fmea from theory to execution. Milwaukee, WI: ASQ Quality Press.

Williams, L. &Wilkins. (2002). Illustrated manual of nursing practice. New York, NY: Author.