Critical failures in the use of home ventilation medical equipment.
Biomedical engineering
Failure analysis
Home care
Home ventilation
Quality in health service
Risk assessment and management
Safety engineering
Swiss cheese model
Journal
Heliyon
ISSN: 2405-8440
Titre abrégé: Heliyon
Pays: England
ID NLM: 101672560
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
24
07
2018
revised:
20
06
2019
accepted:
10
12
2019
entrez:
6
5
2020
pubmed:
6
5
2020
medline:
6
5
2020
Statut:
epublish
Résumé
Home ventilation involves the use of medical devices at patient's home by personnel who are not healthcare practitioners. This implies new potential risks not fully addressed by current standards and guidelines. A methodological approach to investigate potential failures and define improvement actions to address the dangerous potential situations in HV is required. A multidisciplinary team performed an extended version of Failure Mode, Effect and Criticality Analysis (FMECA) to analyse the home ventilation service provided by the Local Healthcare Unit of Naples (ASL NA1) that assisted 60 homebound ventilator dependent patients. The failures were identified in three risk areas: device, electrical system & fire hazard, and indoor air quality. The corrective actions were formulated with two extra steps: identification of critical failures with a threshold applied to the risk priority number and analysis of causes by means of contributory factors (Organization, Technology, Information, and Structure) based on Reason's theory of failures. 22 of 86 potential failures were identified as critical. Specific corrective actions were addressed and proposed through contributory factors to improve the overall quality of home ventilation service. The use of this systemic approach oriented the improvements to reduce the harms caused by vulnerabilities in high-risk care service as life support home ventilation.
Identifiants
pubmed: 32368632
doi: 10.1016/j.heliyon.2019.e03034
pii: S2405-8440(19)36693-9
pii: e03034
pmc: PMC7190690
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e03034Informations de copyright
© 2019 The Authors. Published by Elsevier Ltd.
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