[Objectives]To investigate the effect of healthcare failure mode and effect analysis(HFMEA)on reducing error risk of neonatal parenteral nutrition solution dispensing.[Methods]A research team was established to identi...[Objectives]To investigate the effect of healthcare failure mode and effect analysis(HFMEA)on reducing error risk of neonatal parenteral nutrition solution dispensing.[Methods]A research team was established to identify the failure mode(FM)in each link of the formulation process of neonatal parenteral nutrition solution by HFMEA,quantify the severity(S),occurrence(O)and detection(D)of FM,and evaluate FM by risk priority number(RPN).For FM with the values of RPN>16,failure cause analysis was conducted,and corresponding improvement measures were formulated.The weight coefficient and random consistency ratio(CR)of deployment process were calculated in Matlab R2018a by compiling the Analytic Hierarchy Process(AHP)program.Six months after the implementation of improvement measures,the implementation effect was evaluated by comparing the changes of the values of RPN which was evaluated comprehensively and the rate of dispensing errors before and after the implementation of HFMEA.[Results]In the preparation process of neonatal parenteral nutrition solution,a total of 13 FMs with medium and above risk were found,the weight coefficient of medical order review,dosing and mixing was 0.2703,the weight coefficient of drug dispensing check and review was 0.1432,the weight coefficient of print label was 0.1015,the weight coefficient of distribution was 0.0716,and CR=0.0491<0.1.After six months of intervention,the total RPN value decreased by 64.81%from 127.8 to 45.0.The deployment error rates were significantly lower after the implementation,and the difference was statistically significant(P<0.05).[Conclusions]HFMEA can effectively reduce the error risk in preparation of neonatal parenteral nutrition solution,improve the quality of dispensing and promote the safety of neonatal medication.展开更多
BACKGROUND Craniocerebral injuries encompass brain injuries,skull fractures,cranial soft tissue injuries,and similar injuries.Recently,the incidence of craniocerebral injuries has increased dramatically due to the inc...BACKGROUND Craniocerebral injuries encompass brain injuries,skull fractures,cranial soft tissue injuries,and similar injuries.Recently,the incidence of craniocerebral injuries has increased dramatically due to the increased numbers of traffic accidents and aerial work injuries,threatening the physical and mental health of patients.AIM To investigate the impact of failure modes and effects analysis(FMEA)-based emergency management on craniocerebral injury treatment effectiveness.METHODS Eighty-four patients with craniocerebral injuries,treated at our hospital from November 2019 to March 2021,were selected and assigned,using the random number table method,to study(n=42)and control(n=42)groups.Patients in the control group received conventional management while those in the study group received FMEA theory-based emergency management,based on the control group.Pre-and post-interventions,details regarding the emergency situation;levels of inflammatory stress indicators[Interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)];incidence of complications;prognoses;and satisfaction regarding patient care were evaluated for both groups.RESULTS For the study group,the assessed parameters[pre-hospital emergency response time(9.13±2.37 min),time to receive a consultation(2.39±0.44 min),time needed to report imaging findings(1.15±4.44 min),and test reporting time(32.19±6.23 min)]were shorter than those for the control group(12.78±4.06 min,3.58±0.71 min,33.49±5.51 min,50.41±11.45 min,respectively;P<0.05).Pre-intervention serum levels of IL-6(78.71±27.59 pg/mL),CRP(19.80±6.77 mg/L),and PCT(3.66±1.82 ng/mL)in the study group patients were not significantly different from those in the control group patients(81.31±32.11 pg/mL,21.29±8.02 mg/L,and 3.95±2.11 ng/mL respectively;P>0.05);post-intervention serum indicator levels were lower in both groups than pre-intervention levels.Further,serum levels of IL-6(17.35±5.33 pg/mL),CRP(2.27±0.56 mg/L),and PCT(0.22±0.07 ng/mL)were lower in the study group than in the control group(30.15±12.38 pg/mL,3.13±0.77 mg/L,0.38±0.12 ng/mL,respectively;P<0.05).The complication rate observed in the study group(9.52%)was lower than that in the control group(26.19%,P<0.05).The prognoses for the study group patients were better than those for the control patients(P<0.05).Patient care satisfaction was higher in the study group(95.24%)than in the control group(78.57%,P<0.05).CONCLUSION FMEA-based craniocerebral injury management effectively shortens the time spent on emergency care,reduces inflammatory stress and complication risk levels,and helps improve patient prognoses,while achieving high patient care satisfaction levels.展开更多
Reliability allocation of computerized numerical controlled（CNC）lathes is very important in industry.Traditional allocation methods only focus on high-failure rate components rather than moderate failure rate compon...Reliability allocation of computerized numerical controlled（CNC）lathes is very important in industry.Traditional allocation methods only focus on high-failure rate components rather than moderate failure rate components,which is not applicable in some conditions.Aiming at solving the problem of CNC lathes reliability allocating,a comprehensive reliability allocation method based on cubic transformed functions of failure modes and effects analysis（FMEA）is presented.Firstly,conventional reliability allocation methods are introduced.Then the limitations of direct combination of comprehensive allocation method with the exponential transformed FMEA method are investigated.Subsequently,a cubic transformed function is established in order to overcome these limitations.Properties of the new transformed functions are discussed by considering the failure severity and the failure occurrence.Designers can choose appropriate transform amplitudes according to their requirements.Finally,a CNC lathe and a spindle system are used as an example to verify the new allocation method.Seven criteria are considered to compare the results of the new method with traditional methods.The allocation results indicate that the new method is more flexible than traditional methods.By employing the new cubic transformed function,the method covers a wider range of problems in CNC reliability allocation without losing the advantages of traditional methods.展开更多
It is not objective to rate the decision-making factors in the traditional failure mode and effect analysis,so fuzzy semantic theory is used in this paper.Six fuzzy semantic scales and their corresponding semantics ar...It is not objective to rate the decision-making factors in the traditional failure mode and effect analysis,so fuzzy semantic theory is used in this paper.Six fuzzy semantic scales and their corresponding semantics are summarized,and a defuzzification method is studied to obtain the fuzzy value table of the six fuzzy semantic scales.For the conflicts between experts in the traditional failure mode and effects analysis,a conflict-resolution algorithm is studied to obtain the failure risk order.Finally,a certain type of industrial valve is used as an example to prove the validity of the theory proposed in this paper.展开更多
In view of the low level testability of armored equipment,the important significance of armored equipment testability growth is discussed in this paper.The failure mode effects and criticality analysis( FMECA) method ...In view of the low level testability of armored equipment,the important significance of armored equipment testability growth is discussed in this paper.The failure mode effects and criticality analysis( FMECA) method to realize testability growth is introduced.Centering on the testability growth demands of new armored equipment,the deficiencies of traditional FMECA are analyzed.And an enhanced FMECA( EFMECA) method is proposed.The method increases the analysis contents,combines the information before the failure occurrence and impending failure modes together organically.Then the failure symptoms is analyzed,the failure modes and effects is determined,and the state development trend is predicted.Finally,the application of EFMECA method is illustrated by the example of the failure mode of typical armored equipment engine.展开更多
The recognition and management of risk in donation process and blood product is critical to ensure donor and patient safety. To achieve this goal, the failure mode and effects analysis (FMEA) is a convenient method;mo...The recognition and management of risk in donation process and blood product is critical to ensure donor and patient safety. To achieve this goal, the failure mode and effects analysis (FMEA) is a convenient method;moreover it was used to prevent the occurrence of adverse events and look at what could go strong at each step. This study aimed to utilize FMEA in central blood bank in Khartoum to evaluate the potential risk and adverse event that may occur during the donation process. According to the severity, occurrence and the detection of each failure mode, the risk priority number (RPN) was calculated to determine which of the failures should take priority to find a solution and applying corrective action to reduce the failure risk. The statistical package for social sciences (SPSS) version 11 was used as descriptive and analytical statistics tool. The FMEA technique provides a systematic method for finding vulnerabilities in a process before they result in an error, and in this study a satisfactory outcome was reached.展开更多
Failure mode and effects analysis （FMEA） offers a quick and easy way for identifying ranking-order for all failure modes in a system or a product. In FMEA the ranking methods is so called risk priority number （RPN...Failure mode and effects analysis （FMEA） offers a quick and easy way for identifying ranking-order for all failure modes in a system or a product. In FMEA the ranking methods is so called risk priority number （RPN）, which is a mathematical product of severity （S）, occurrence （0）, and detection （D）. One of major disadvantages of this ranking-order is that the failure mode with different combination of SODs may generate same RPN resulting in difficult decision-making. Another shortfall of FMEA is lacking of discerning contribution factors, which lead to insufficient information about scaling of improving effort. Through data envelopment analysis （DEA） technique and its extension, the proposed approach evolves the current rankings for failure modes by exclusively investigating SOD in lieu of RPN and to furnish with improving sca.les for SOD. The purpose of present study is to propose a state-of-the-art new approach to enhance assessment capabilities of failure mode and effects analysis （FMEA）. The paper proposes a state-of-the-art new approach, robust, structured and useful in practice, for failure analysis.展开更多
目的探讨医疗失效模式与效应分析(healthfailuremode and effect analysis,HFMEA)在腹腔镜手术中转开放手术配合中的应用效果。方法选取2022年1—6月厦门大学附属第一医院收治的718例腹腔镜手术患者作为实施前;选取2022年7—12月厦门大...目的探讨医疗失效模式与效应分析(healthfailuremode and effect analysis,HFMEA)在腹腔镜手术中转开放手术配合中的应用效果。方法选取2022年1—6月厦门大学附属第一医院收治的718例腹腔镜手术患者作为实施前;选取2022年7—12月厦门大学附属第一医院收治的662例腹腔镜手术患者作为实施后。2022年6月组建跨专业的多学科小组,梳理腹腔镜手术中转开放手术实施的关键环节,对中转开放手术实施过程中可能出现的失效模式进行严重度、发生的可能性、探测的可能性评分,根据危害评分矩阵评估风险优先指数(risk priority number,RPN),针对RPN>125分的5项失效模式进行改进。比较实施前后的RPN和应急抢救配合满意度。结果腹腔镜手术中转开放手术安全管理体系中包括手术间管理不符合要求、人员管理不符合要求、临床实施操作不规范、仪器及设备运行失效、手术护理记录不规范5个方面17个风险点;其中有8个风险点需要采取措施进行控制,实施控制措施后,8个风险点的RPN值均有下降,且均<8分。手术医护团队对于实施腹腔镜手术中转开放手术管理策略的实践均表示认可。结论基于HFMEA对腹腔镜手术中转开放手术配合应急抢救进行风险识别及评估,建立腹腔镜手术中转开放手术配合安全管理机制,可有效降低腹腔镜手术中转开放手术配合应急抢救RPN,保障腹腔镜手术中转开放手术配合顺利,保障患者安全。展开更多
A new method of system failure analysis was proposed. First, considering the relationships between the failure subsystems,the decision making trial and evaluation laboratory(DEMATEL) method was used to calculate the d...A new method of system failure analysis was proposed. First, considering the relationships between the failure subsystems,the decision making trial and evaluation laboratory(DEMATEL) method was used to calculate the degree of correlation between the failure subsystems, analyze the combined effect of related failures, and obtain the degree of correlation by using the directed graph and matrix operations. Then, the interpretative structural modeling(ISM) method was combined to intuitively show the logical relationship of many failure subsystems and their influences on each other by using multilevel hierarchical structure model and obtaining the critical subsystems. Finally, failure mode effects and criticality analysis(FMECA) was used to perform a qualitative hazard analysis of critical subsystems, determine the critical failure mode, and clarify the direction of reliability improvement.Through an example, the result demonstrates that the proposed method can be efficiently applied to system failure analysis problems.展开更多
The failure modes and effects analysis （FMEA） is widely applied in manufacturing industries in various phases of the product life cycle to evaluate the system, its design and processes for failures that can occur. T...The failure modes and effects analysis （FMEA） is widely applied in manufacturing industries in various phases of the product life cycle to evaluate the system, its design and processes for failures that can occur. The FMEA team often demonstrates different opinions and these different types of opinions are very difficult to incorporate into the FMEA by the traditional risk priority number model. In this paper, for each of the Occurrence, Severity and Detectivity parameters a fuzzy set is defined and the opinion of each FMEA team members is considered. These opinions are considered simultaneously with weights that are given to each individual based on their skills and experience levels. In addition, the opinion of the costumer is considered for each of the FMEA parameters. Then, the Risk Priority Numbers （RPN） is calculated using a Multi Input Single Output （MISO） fuzzy expert system. The proposed model is applied for prioritizing the failures of Peugeot 206 Engine assembly line in IKCo （Iran Khodro Company）.展开更多
基金Young Scholar Program of Hebei Pharmaceutical Association Hospital Pharmaceutical Research Project(2020—Hbsyxhqn0029)Science and Technology Research and Development Project of Chengde City,Hebei Province(201706A043).
文摘[Objectives]To investigate the effect of healthcare failure mode and effect analysis(HFMEA)on reducing error risk of neonatal parenteral nutrition solution dispensing.[Methods]A research team was established to identify the failure mode(FM)in each link of the formulation process of neonatal parenteral nutrition solution by HFMEA,quantify the severity(S),occurrence(O)and detection(D)of FM,and evaluate FM by risk priority number(RPN).For FM with the values of RPN>16,failure cause analysis was conducted,and corresponding improvement measures were formulated.The weight coefficient and random consistency ratio(CR)of deployment process were calculated in Matlab R2018a by compiling the Analytic Hierarchy Process(AHP)program.Six months after the implementation of improvement measures,the implementation effect was evaluated by comparing the changes of the values of RPN which was evaluated comprehensively and the rate of dispensing errors before and after the implementation of HFMEA.[Results]In the preparation process of neonatal parenteral nutrition solution,a total of 13 FMs with medium and above risk were found,the weight coefficient of medical order review,dosing and mixing was 0.2703,the weight coefficient of drug dispensing check and review was 0.1432,the weight coefficient of print label was 0.1015,the weight coefficient of distribution was 0.0716,and CR=0.0491<0.1.After six months of intervention,the total RPN value decreased by 64.81%from 127.8 to 45.0.The deployment error rates were significantly lower after the implementation,and the difference was statistically significant(P<0.05).[Conclusions]HFMEA can effectively reduce the error risk in preparation of neonatal parenteral nutrition solution,improve the quality of dispensing and promote the safety of neonatal medication.
基金Supported by Basic Research on Medical and Health Application of the People's Livelihood Science and Technology Project of Suzhou Science and Technology Bureau,No.SYS2020102.
文摘BACKGROUND Craniocerebral injuries encompass brain injuries,skull fractures,cranial soft tissue injuries,and similar injuries.Recently,the incidence of craniocerebral injuries has increased dramatically due to the increased numbers of traffic accidents and aerial work injuries,threatening the physical and mental health of patients.AIM To investigate the impact of failure modes and effects analysis(FMEA)-based emergency management on craniocerebral injury treatment effectiveness.METHODS Eighty-four patients with craniocerebral injuries,treated at our hospital from November 2019 to March 2021,were selected and assigned,using the random number table method,to study(n=42)and control(n=42)groups.Patients in the control group received conventional management while those in the study group received FMEA theory-based emergency management,based on the control group.Pre-and post-interventions,details regarding the emergency situation;levels of inflammatory stress indicators[Interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)];incidence of complications;prognoses;and satisfaction regarding patient care were evaluated for both groups.RESULTS For the study group,the assessed parameters[pre-hospital emergency response time(9.13±2.37 min),time to receive a consultation(2.39±0.44 min),time needed to report imaging findings(1.15±4.44 min),and test reporting time(32.19±6.23 min)]were shorter than those for the control group(12.78±4.06 min,3.58±0.71 min,33.49±5.51 min,50.41±11.45 min,respectively;P<0.05).Pre-intervention serum levels of IL-6(78.71±27.59 pg/mL),CRP(19.80±6.77 mg/L),and PCT(3.66±1.82 ng/mL)in the study group patients were not significantly different from those in the control group patients(81.31±32.11 pg/mL,21.29±8.02 mg/L,and 3.95±2.11 ng/mL respectively;P>0.05);post-intervention serum indicator levels were lower in both groups than pre-intervention levels.Further,serum levels of IL-6(17.35±5.33 pg/mL),CRP(2.27±0.56 mg/L),and PCT(0.22±0.07 ng/mL)were lower in the study group than in the control group(30.15±12.38 pg/mL,3.13±0.77 mg/L,0.38±0.12 ng/mL,respectively;P<0.05).The complication rate observed in the study group(9.52%)was lower than that in the control group(26.19%,P<0.05).The prognoses for the study group patients were better than those for the control patients(P<0.05).Patient care satisfaction was higher in the study group(95.24%)than in the control group(78.57%,P<0.05).CONCLUSION FMEA-based craniocerebral injury management effectively shortens the time spent on emergency care,reduces inflammatory stress and complication risk levels,and helps improve patient prognoses,while achieving high patient care satisfaction levels.
基金Supported by National Natural Science Foundation of China(Grant Nos.51135003,51205050,U1234208)Key National Science & Technology Special Project on"High-Grade CNC Machine Tools and Basic Manufacturing Equipments"(Grant No.2013ZX04011011)+1 种基金Research Fund for the Doctoral Program of Higher Education of China(Grant No.20110042120020)Fundamental Research Funds for the Central
文摘Reliability allocation of computerized numerical controlled（CNC）lathes is very important in industry.Traditional allocation methods only focus on high-failure rate components rather than moderate failure rate components,which is not applicable in some conditions.Aiming at solving the problem of CNC lathes reliability allocating,a comprehensive reliability allocation method based on cubic transformed functions of failure modes and effects analysis（FMEA）is presented.Firstly,conventional reliability allocation methods are introduced.Then the limitations of direct combination of comprehensive allocation method with the exponential transformed FMEA method are investigated.Subsequently,a cubic transformed function is established in order to overcome these limitations.Properties of the new transformed functions are discussed by considering the failure severity and the failure occurrence.Designers can choose appropriate transform amplitudes according to their requirements.Finally,a CNC lathe and a spindle system are used as an example to verify the new allocation method.Seven criteria are considered to compare the results of the new method with traditional methods.The allocation results indicate that the new method is more flexible than traditional methods.By employing the new cubic transformed function,the method covers a wider range of problems in CNC reliability allocation without losing the advantages of traditional methods.
基金National Natural Science Foundation of China(No.51565019)the Scientific Research Start-Up Program of Tongji University,China(No.20141110)
文摘It is not objective to rate the decision-making factors in the traditional failure mode and effect analysis,so fuzzy semantic theory is used in this paper.Six fuzzy semantic scales and their corresponding semantics are summarized,and a defuzzification method is studied to obtain the fuzzy value table of the six fuzzy semantic scales.For the conflicts between experts in the traditional failure mode and effects analysis,a conflict-resolution algorithm is studied to obtain the failure risk order.Finally,a certain type of industrial valve is used as an example to prove the validity of the theory proposed in this paper.
文摘In view of the low level testability of armored equipment,the important significance of armored equipment testability growth is discussed in this paper.The failure mode effects and criticality analysis( FMECA) method to realize testability growth is introduced.Centering on the testability growth demands of new armored equipment,the deficiencies of traditional FMECA are analyzed.And an enhanced FMECA( EFMECA) method is proposed.The method increases the analysis contents,combines the information before the failure occurrence and impending failure modes together organically.Then the failure symptoms is analyzed,the failure modes and effects is determined,and the state development trend is predicted.Finally,the application of EFMECA method is illustrated by the example of the failure mode of typical armored equipment engine.
文摘The recognition and management of risk in donation process and blood product is critical to ensure donor and patient safety. To achieve this goal, the failure mode and effects analysis (FMEA) is a convenient method;moreover it was used to prevent the occurrence of adverse events and look at what could go strong at each step. This study aimed to utilize FMEA in central blood bank in Khartoum to evaluate the potential risk and adverse event that may occur during the donation process. According to the severity, occurrence and the detection of each failure mode, the risk priority number (RPN) was calculated to determine which of the failures should take priority to find a solution and applying corrective action to reduce the failure risk. The statistical package for social sciences (SPSS) version 11 was used as descriptive and analytical statistics tool. The FMEA technique provides a systematic method for finding vulnerabilities in a process before they result in an error, and in this study a satisfactory outcome was reached.
文摘Failure mode and effects analysis （FMEA） offers a quick and easy way for identifying ranking-order for all failure modes in a system or a product. In FMEA the ranking methods is so called risk priority number （RPN）, which is a mathematical product of severity （S）, occurrence （0）, and detection （D）. One of major disadvantages of this ranking-order is that the failure mode with different combination of SODs may generate same RPN resulting in difficult decision-making. Another shortfall of FMEA is lacking of discerning contribution factors, which lead to insufficient information about scaling of improving effort. Through data envelopment analysis （DEA） technique and its extension, the proposed approach evolves the current rankings for failure modes by exclusively investigating SOD in lieu of RPN and to furnish with improving sca.les for SOD. The purpose of present study is to propose a state-of-the-art new approach to enhance assessment capabilities of failure mode and effects analysis （FMEA）. The paper proposes a state-of-the-art new approach, robust, structured and useful in practice, for failure analysis.
基金Project(51275205)supported by the National Natural Science Foundation of China
文摘A new method of system failure analysis was proposed. First, considering the relationships between the failure subsystems,the decision making trial and evaluation laboratory(DEMATEL) method was used to calculate the degree of correlation between the failure subsystems, analyze the combined effect of related failures, and obtain the degree of correlation by using the directed graph and matrix operations. Then, the interpretative structural modeling(ISM) method was combined to intuitively show the logical relationship of many failure subsystems and their influences on each other by using multilevel hierarchical structure model and obtaining the critical subsystems. Finally, failure mode effects and criticality analysis(FMECA) was used to perform a qualitative hazard analysis of critical subsystems, determine the critical failure mode, and clarify the direction of reliability improvement.Through an example, the result demonstrates that the proposed method can be efficiently applied to system failure analysis problems.
文摘The failure modes and effects analysis （FMEA） is widely applied in manufacturing industries in various phases of the product life cycle to evaluate the system, its design and processes for failures that can occur. The FMEA team often demonstrates different opinions and these different types of opinions are very difficult to incorporate into the FMEA by the traditional risk priority number model. In this paper, for each of the Occurrence, Severity and Detectivity parameters a fuzzy set is defined and the opinion of each FMEA team members is considered. These opinions are considered simultaneously with weights that are given to each individual based on their skills and experience levels. In addition, the opinion of the costumer is considered for each of the FMEA parameters. Then, the Risk Priority Numbers （RPN） is calculated using a Multi Input Single Output （MISO） fuzzy expert system. The proposed model is applied for prioritizing the failures of Peugeot 206 Engine assembly line in IKCo （Iran Khodro Company）.
