PMID- 23560475
OWN - NLM
STAT- MEDLINE
DCOM- 20140203
LR  - 20220311
IS  - 1537-2995 (Electronic)
IS  - 0041-1132 (Linking)
VI  - 53
IP  - 12
DP  - 2013 Dec
TI  - Failure mode and effect analysis in blood transfusion: a proactive tool to reduce 
      risks.
PG  - 3080-7
LID - 10.1111/trf.12174 [doi]
AB  - BACKGROUND: The aim of blood transfusion risk management is to improve the 
      quality of blood products and to assure patient safety. We utilize failure mode 
      and effect analysis (FMEA), a tool employed for evaluating risks and identifying 
      preventive measures to reduce the risks in blood transfusion. STUDY DESIGN AND 
      METHODS: The failure modes and effects occurring throughout the whole process of 
      blood transfusion were studied. Each failure mode was evaluated using three 
      scores: severity of effect (S), likelihood of occurrence (O), and probability of 
      detection (D). Risk priority numbers (RPNs) were calculated by multiplying the S, 
      O, and D scores. The plan-do-check-act cycle was also used for continuous 
      improvement. RESULTS: Analysis has showed that failure modes with the highest 
      RPNs, and therefore the greatest risk, were insufficient preoperative assessment 
      of the blood product requirement (RPN, 245), preparation time before infusion of 
      more than 30 minutes (RPN, 240), blood transfusion reaction occurring during the 
      transfusion process (RPN, 224), blood plasma abuse (RPN, 180), and insufficient 
      and/or incorrect clinical information on request form (RPN, 126). After 
      implementation of preventative measures and reassessment, a reduction in RPN was 
      detected with each risk. The failure mode with the second highest RPN, namely, 
      preparation time before infusion of more than 30 minutes, was shown in detail to 
      prove the efficiency of this tool. CONCLUSIONS: FMEA evaluation model is a useful 
      tool in proactively analyzing and reducing the risks associated with the blood 
      transfusion procedure.
CI  - (c) 2013 American Association of Blood Banks.
FAU - Lu, Yao
AU  - Lu Y
AD  - Department of Blood Transfusion, Research Institute of Surgery, Daping Hospital, 
      Third Military Medical University, Chongqing, P.R. China; Department of Quality 
      Control, Research Institute of Surgery, Daping Hospital, Third Military Medical 
      University, Chongqing, P.R. China.
FAU - Teng, Fang
AU  - Teng F
FAU - Zhou, Jie
AU  - Zhou J
FAU - Wen, Aiqing
AU  - Wen A
FAU - Bi, Yutian
AU  - Bi Y
LA  - eng
PT  - Journal Article
DEP - 20130408
PL  - United States
TA  - Transfusion
JT  - Transfusion
JID - 0417360
SB  - IM
MH  - Humans
MH  - Risk Assessment
MH  - Risk Management
MH  - *Transfusion Reaction
EDAT- 2013/04/09 06:00
MHDA- 2014/02/04 06:00
CRDT- 2013/04/09 06:00
PHST- 2012/04/23 00:00 [received]
PHST- 2013/01/31 00:00 [revised]
PHST- 2013/01/31 00:00 [accepted]
PHST- 2013/04/09 06:00 [entrez]
PHST- 2013/04/09 06:00 [pubmed]
PHST- 2014/02/04 06:00 [medline]
AID - 10.1111/trf.12174 [doi]
PST - ppublish
SO  - Transfusion. 2013 Dec;53(12):3080-7. doi: 10.1111/trf.12174. Epub 2013 Apr 8.