Unidad de Radiofarmacia, Servicio de Medicina Nuclear, Hospital Clínic, Barcelona, Spain.
Unidad de Radiofarmacia, Servicio de Medicina Nuclear, Hospital Clínic, Barcelona, Spain.
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2022 Sep-Oct;41(5):300-310. doi: 10.1016/j.remnie.2022.05.001. Epub 2022 Jun 3.
The aim of this study is the implementation in a Hospital Radiopharmacy Unit of a risk analysis methodology in order to proactively identify possible failure modes and prioritize corrective measures.
By means of the failure modes and effects analysis (FMEA), the possible failure modes of each of the stages of the processes of prescription, preparation, and administration of radiopharmaceuticals for diagnostic and therapy were identified. From the variables of severity, probability and detectability, the risk was quantified using the Risk Priority Number (RPN) for each failure mode, sub-process, and type of radiopharmaceutical. Improvement measures were established and the reduction in the RPN value was calculated.
A total of 96 failure modes were identified (58 for diagnostic radiopharmaceuticals and 38 for therapy). Biunivocal identification of the patient with the radiopharmaceutical is the failure mode with the highest RPN (60) and the radiolabeling cell sub-process the one that has the highest risk (RPN 286). As a result of the improvement measures, the overall RPN was reduced by 22% for diagnostic radiopharmaceuticals and 20% for therapy. This reduction would be 46% and 31% respectively if radiopharmacy software and a barcode technology in the administration were implemented.
The application of the FMEA methodology as a risk analysis tool allows to identify the critical points of the processes related to radiopharmaceuticals and prioritize measures to reduce the risk.
本研究旨在医院放射药房实施风险分析方法,以主动识别可能的故障模式并确定优先纠正措施。
通过失效模式和影响分析(FMEA),确定了用于诊断和治疗的放射性药物的处方、制备和管理过程的每个阶段的可能失效模式。根据严重程度、发生概率和可检测性等变量,使用风险优先数(RPN)对每个失效模式、子过程和放射性药物类型进行风险量化。制定了改进措施,并计算了 RPN 值的降低。
共发现 96 种失效模式(诊断放射性药物 58 种,治疗放射性药物 38 种)。患者与放射性药物的双向识别是 RPN 最高的失效模式(60),放射性标记细胞子过程是风险最高的(RPN 286)。通过改进措施,诊断放射性药物的整体 RPN 降低了 22%,治疗放射性药物的整体 RPN 降低了 20%。如果实施放射药房软件和给药过程中的条形码技术,整体 RPN 将分别降低 46%和 31%。
FMEA 方法作为风险分析工具的应用可以识别与放射性药物相关的过程中的关键点,并确定降低风险的优先措施。