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应用失效模式与影响分析(FMEA)对肺癌患者药物使用风险进行分析。

Use of Failure Mode and Effects Analysis (FMEA) for Risk Analysis of Drug Use in Patients with Lung Cancer.

机构信息

The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an 710061, China.

The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an 710061, China.

出版信息

Int J Environ Res Public Health. 2022 Nov 22;19(23):15428. doi: 10.3390/ijerph192315428.

Abstract

It is crucial to investigate the risk factors inherent in the medication process for cancer patients since improper antineoplastic drug use frequently has serious consequences. As a result, the Severity, Occurrence, and Detection rate of each potential failure mode in the drug administration process for patients with lung cancer were scored using the Failure Mode and Effect Analysis (FMEA) model in this study. Then, the risk level of each failure mode and the direction of improvement were investigated using the Slacks-based measure data envelopment analysis (SBM-DEA) model. According to the findings, the medicine administration process for lung cancer patients could be classified into five links, with a total of 60 failure modes. The risk of failure modes for patient medication and post-medication monitoring ranked highly, with unauthorized use of traditional Chinese medicine and folk prescription and unauthorized drug addition (incorrect self-medication) ranking first (1/60); doctor prescription was also prone to errors. The study advises actively looking at ways to decrease the occurrence and difficulty of failure mode detection to continually enhance patient safety when using medications.

摘要

对于癌症患者而言,探究药物治疗过程中固有的风险因素十分重要,因为抗肿瘤药物使用不当往往会产生严重后果。因此,本研究采用失效模式与影响分析(Failure Mode and Effect Analysis,FMEA)模型对肺癌患者药物治疗过程中每个潜在失效模式的严重度、发生度和检出度进行评分,再利用基于松弛变量的数据包络分析(Slacks-based measure data envelopment analysis,SBM-DEA)模型研究各失效模式的风险水平和改进方向。研究结果显示,肺癌患者的药物治疗过程可分为 5 个环节,共计 60 个失效模式。患者用药和用药后监测环节的失效模式风险较高,其中排名首位的是中药和民间处方的不合理使用(自行用药不当)以及不合理加药(用药错误)(1/60),其次是医生处方也容易出现错误。研究建议积极寻找降低失效模式发生度和检测难度的方法,持续提高患者用药安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a095/9739421/d4f9a2c560ae/ijerph-19-15428-g001.jpg

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