Failure Mode And Effects Analysis (FMEA)

C. FMEA

Failure Mode and Effects Analysis (FMEA) is a specific process that focuses on ways to prevent problems or sentinel events before they occur, rather than a specific event. FMEA uses a multidisciplinary group of selected people that meet regularly to 1) identify a process that needs to be evaluated, improved and or identify a process that may fail and give examples of how these processes may fail. In the scenario of Mr. B. and the moderate sedation in the E.R., the process that needs to be evaluated and improved would be the moderate sedation policy itself to list more specific rules of what is required during the sedation procedure and following in the recovery period. In this particular failure mode some areas that may fail in the
To do so, it should be on a smaller, easier to evaluate level and track the results as one goes along. By testing on a smaller level, one can see what is working and what is not working in the plan and tweak the details for a more positive conclusion. An example of testing changes on a smaller level would be what is called a Plan, Do, Study, Act (PDSA) cycle. The PDSA cycle plan tests changes by preparing for the change, trying out the plan, watching for what the outcome may be and proceeding based on what that outcome
In this case scenario a better defined policy on moderate sedation should be listed out step by step that will prevent any further sentinel events. For example, describing the process of change through a flowchart of what those steps are. In this case, updating the policy to include one on one staffing for a qualified nurse to monitor the patient during and until discharge criteria is met within the E.R. environment. Than putting a clause to the moderate sedation drugs used for patients that may include: older than 65 years, like Mr. B, has a chronic illness that may affect the reaction of the medications and or has been on chronic narcotic medication such as Mr. B. had been. Educating staff and providing reasons why the change is needed and appealing to the staff’s “Do no Harm” motto and providing training sessions and then implementing the changes. The second pre-step in preparing for implementing the FMEA is identifying what could go wrong with each step of the plan. For this particular case scenario the first step of the plan is updating the policy to include one on one staffing. What is there is no extra staff available to help and a moderate sedation is planned to be used? Than everyone on the planning phase can try to solve that dilemma like always have one ACLS, trained nurse in moderate sedation on call twenty four hours a day. What if the