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基于理论的用药错误失效模式与效应分析。

Theory-Based Failure Modes and Effect Analysis for Medication Errors.

机构信息

Faculty of Industrial Engineering, Urmia University of Technology, Urmia, Iran.

Department of Mechanical and Manufacturing Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia.

出版信息

J Healthc Eng. 2021 Mar 31;2021:5533208. doi: 10.1155/2021/5533208. eCollection 2021.

Abstract

Medication Errors (MEs) are still significant challenges, especially in nonautomated health systems. Qualitative studies are mostly used to identify the parameters involved in MEs. Failing to provide accurate information in expert-based decisions can provoke unrealistic results and inappropriate corrective actions eventually. However, mostly, some levels of uncertainty accompany the decisions in real practice. This study tries to present a hybrid decision-making approach to assigning different weights to risk factors and considering the uncertainty in the ranking process in the Failure Modes and Effect Analysis (FMEA) technique. Initially, significant MEs are identified by three groups of qualified experts (doctors, nurses, and pharmacists). Afterward, for assigning weights to the risk factors, -number couples with the Stepwise Weight Assessment Ratio Analysis (SWARA) method, named -SWARA, to add reliability concept in the decision-making process. Finally, the identified MEs are ranked through the developed Weighted Aggregated Sum Product Assessment (WASPAS) method, namely, -WASPAS. To demonstrate the applicability of the proposed approach, the ranking results compare with typical methods, such as fuzzy-WASPAS and FMEA. The findings of the present study highlight improper medication administration as the main failure mode, which can result in a fatality or patient injury. Moreover, the utilization of multiple-criteria decision-making methods in combination with -number can be a useful tool in the healthcare management field since it can address the problems by considering reliability and uncertainty simultaneously.

摘要

药物错误(MEs)仍然是一个重大挑战,尤其是在非自动化医疗系统中。定性研究主要用于确定 ME 涉及的参数。在基于专家的决策中未能提供准确信息可能会导致不切实际的结果和最终不适当的纠正措施。然而,在实际实践中,决策通常伴随着一定程度的不确定性。本研究试图提出一种混合决策方法,为风险因素分配不同的权重,并考虑失效模式和影响分析(FMEA)技术中排名过程的不确定性。最初,三组合格专家(医生、护士和药剂师)确定了重大 ME。此后,为了给风险因素分配权重,使用 -number 与逐步权重评估比分析(SWARA)方法,即 -SWARA,在决策过程中添加可靠性概念。最后,通过开发的加权聚合和乘积评估(WASPAS)方法,即 -WASPAS,对确定的 ME 进行排名。为了证明所提出方法的适用性,将排名结果与模糊-WASPAS 和 FMEA 等典型方法进行比较。本研究的结果强调了不当的药物管理是主要的失效模式,可能导致死亡或患者受伤。此外,多准则决策方法与 -number 的结合可以成为医疗保健管理领域的有用工具,因为它可以通过同时考虑可靠性和不确定性来解决问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e57/8032513/927160a7c11f/JHE2021-5533208.001.jpg

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