Nuova Itor, Clinica accreditata, 00158 Rome, Italy.
Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy.
Int J Environ Res Public Health. 2022 Dec 7;19(24):16430. doi: 10.3390/ijerph192416430.
Correct perioperative management of anticoagulant therapy is essential to prevent thromboembolic events and reduce the risk of bleeding. The lack of universally accepted guidelines makes perioperative anticoagulant therapy management difficult. The present study aims to identify the perioperative risks of oral anticoagulant therapy and to reduce adverse events through Failure Mode and Effect Analysis (FMEA).
A multidisciplinary working group was set up, and four main phases of the process were identified. Each of these phases was divided into micro-activities to identify the related possible failure modes and their potential consequences. The Risk Priority Number was calculated for each failure mode.
Seventeen failure modes were identified in the entire perioperative period; those with a higher priority of intervention concern the incorrect timing between therapy suspension and surgery, and the incorrect assessment of the bleeding risk related to the invasive procedure.
The FMEA method can help identify anticoagulant therapy perioperative failures and implement the management and patient safety of surgical procedures.
正确的围手术期抗凝治疗管理对于预防血栓栓塞事件和降低出血风险至关重要。缺乏普遍接受的指南使得围手术期抗凝治疗管理变得困难。本研究旨在通过失效模式和影响分析（FMEA）确定口服抗凝治疗的围手术期风险，并减少不良事件。
成立了一个多学科工作组，并确定了该过程的四个主要阶段。每个阶段都分为微观活动，以确定相关的可能失效模式及其潜在后果。为每个失效模式计算了风险优先数。
在整个围手术期共发现了 17 种失效模式；干预优先级较高的失效模式涉及治疗暂停和手术之间的时间不正确，以及对与侵入性手术相关的出血风险的评估不正确。
FMEA 方法可帮助识别抗凝治疗围手术期失败，并实施手术过程的管理和患者安全。
