title: Use of a risk assessment method to improve the safety of negative pressure wound therapy.
abstract: To conduct a risk analysis of the negative pressure wound therapy (NPWT) care process and to improve the safety of NPWT, a working group of nurses, hospital pharmacists, physicians and hospital managers performed a risk analysis for the process of NPWT care. The failure modes, effects and criticality analysis (FMECA) method was used for this analysis. Failure modes and their consequences were defined and classified as a function of their criticality to identify priority actions for improvement. By contrast to classical FMECA, the criticality index (CI) of each consequence was calculated by multiplying occurrence, severity and detection scores. We identified 13 failure modes, leading to 20 different consequences. The CI of consequences was initially 712, falling to 357 after corrective measures were implemented. The major improvements proposed included the establishment of 6-monthly training cycles for nurses, physicians and surgeons and the introduction of computerised prescription for NPWT. The FMECA method also made it possible to prioritise actions as a function of the criticality ranking of consequences and was easily understood and used by the working group. This study is, to our knowledge, the first to use the FMECA method to improve the safety of NPWT.
authors.affiliation: Pharmacy Department, Georges Pompidou European Hospital AP-HP, Paris, FrancePharmacy Department, Foch Hospital, Suresnes, France.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Lelong
authors.forename: Nicolas
authors.initials: N
authors.lastname: Martelli
authors.forename: Brigitte
authors.initials: B
authors.lastname: Bonan
authors.forename: Patrice
authors.initials: P
authors.lastname: Prognon
authors.forename: Judith
authors.initials: J
authors.lastname: Pineau
mesh_terms: D002983:Clinical Competence; D006282:Health Personnel; D006801:Humans; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D061214:Patient Safety / Q000592:standards; D058996:Quality Improvement; D018570:Risk Assessment / Q000379:methods*; D017751:Safety Management / Q000379:methods*; D014947:Wounds and Injuries / Q000628:therapy*