Risk Assessment of Clinical Care in Emergency Departments
by Health Failure Modes and Effects Analysis

Risk Assessment of Clinical Care in Emergency Departments
by Health Failure Modes and Effects Analysis

Risk assessment, Nursing
care, Emergency department,
Patient safety

Introduction: Medical errors are among significant health system problems. The best method
to detect errors is to identify the root and systemic causes of errors.
Objective: This study aimed to investigate the failures of clinical care in emergency
departments using the Healthcare Failure Modes and Effects Analysis (HFMEA).
Materials and Methods: This was an analytical and cross-sectional study. The required data
were collected qualitatively and quantitatively using focus group discussions in emergency
departments. The study population consisted of all emergency department nurses. Study
samples were selected by purposive sampling technique. By the HFMEA method, Risk
Priority Number (RPN) was calculated to reach failure modes and those with RPN >216
were identified as the most frequent and risky errors.
Results: A total number of 67 failure modes were identified for 26 clinical care processes.The
errors with the highest RPN were “the lack of oxygenation during airway suctioning” and “the
lack of airway suctioning during ventilator weaning process”; they related to the respiratory
system care with RPN=336. The error with the lowest RPN was “the lack of signing verbal
orders by two nurses”; related to the general practice with RPN=8.
Conclusion: Investigating the causes and effects of these errors, controlling, and suggesting
measures indicate the high efficiency of the HFMEA method. It also suggested the
preventability of these errors by increasing the knowledge and awareness of the training staff
by providing training courses

Leila Moradi , Abdolhosein Emami Sigaroudi, Majid Pourshaikhian, Mahmood Heidari

Negah Institute for Scientific Communication

05 Juni 2023

Fajar Bagus W

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