Chemotherapy-related risk management toward safe administration of medications: Apply failure mode and effects analysis to reduce the incidence of chemotherapy errors.

Chemotherapy is considered a high-risk procedure where system failures are more likely to occur. Failure mode and effects analysis (FMEA) is a systematic, multidisciplinary team-based approach to error prevention. We described our experience of using FMEA as a prospective risk-management technique throughout the chemotherapy process. The occurrence, detectability and severity were assessed. Fifteen potential risk factors associated with 10 failure modes were identified. Improvement measures were proposed according to risk priority number. A computerized physician order entry (CPOE) and complete prescription audit system (CPAS) were introduced to reduce potential risks during chemotherapy. Introduction of this system was associated with a decrease from 2.60% to 0.60%. As a result, FMEA is a useful tool to evaluate potential risk in healthcare processes.