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Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/33603

Title: A Healthcare Failure Mode and Effect Analysis on the Safety of Secondary Infusions
Authors: Yue, Ying Kwan
Advisor: Easty, Anthony
Trbovich, Patricia
Department: Biomedical Engineering
Keywords: HFMEA
human factors
secondary infusion
piggyback infusion
intravenous medication safety
smart infusion pump
Issue Date: 27-Nov-2012
Abstract: Secondary infusions are a common and convenient method to administer intermittent infusions unattended through a single IV access using infusion pump technology. Previous studies have indicated that clinicians have a high frequency of committing operation errors while administering secondary infusions, which can cause patient harm. The purpose of this study was to evaluate the safety of secondary infusion practice by identifying and analyzing potential failure modes when delivering secondary infusions on five different smart infusion pumps. Healthcare Failure Mode and Effect Analysis (HFMEA) was used to prioritize potential failure modes that are considered high-risk for each pump. Results showed that four of the five pumps were not able to mitigate physical set-up errors. As well, each pump contributed differently to programming errors due to difference in interface design. Recommendations from this study focused on outlining desired infusion pump features and mitigation strategies to help alleviate high-risk secondary infusion failure modes.
URI: http://hdl.handle.net/1807/33603
Appears in Collections:Master

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