AMDEC sur l’administration des médicaments

Dans le blogue du 1 avril 2011, nous vous avons partagé l’affiche du projet AMÉLIE. Nous vous invitons maintenant à consulter l’article découlant de ce projet qui avait comme objectif de réaliser une analyse des modes de défaillances, de leurs effets et de leur criticité (AMDEC) sur le processus d’administration des médicaments.

Le résumé du projet se trouve ci-dessous :

OBJECTIVE: The objective of this article was to critically evaluate the causes of adverse drug events during the nurse medication administration process in paediatric care units in order to identify and prioritize interventions that need to be implemented.

METHODOLOGY: This is a failure mode, effects and criticality analysis (FMECA) study. A multidisciplinary committee composed of nurses, pharmacists, physicians and risk managers evaluated through consensus the process of administering medications at the Centre hospitalier universitaire de Sainte-Justine. By mapping the process, all the failure modes were identified and associated with at least one cause each. Using a summary grid, each failure mode was evaluated by rating frequency (from 1 to 9), likelihood of failure detection (from 0 to 100%) and severity (from 1 to 9) using adapted versions of already published scales.

RESULTS: A 10-member committee was set up, and it met eight times between January and April 2010. In the two specialized paediatric units selected (n = 38 beds), an average number of approximately 20 000 drug doses was administered monthly from about 400 non-proprietary names. Through consensus, the committee identified 16 processes and 53 failure modes. While frequency and severity were based on perceptions that could be objectivized with local data and scientific documentation, the likelihood of detection was mainly based on individual perception.

CONCLUSION: FMECA is a useful approach to improve the medication process.

Vous pouvez consulter notre article publié dans le Journal of Evaluation in Clinical Practice.