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Proactive Risk Assessment through Failure Mode and Effect Analysis (FMEA) for Perioperative Management Model of Oral Anticoagulant Therapy: A Pilot Project

Author

Listed:
  • Fausta Micheletta

    (Nuova Itor, Clinica accreditata, 00158 Rome, Italy
    These authors contributed equally to this work.)

  • Michela Ferrara

    (Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy
    These authors contributed equally to this work.)

  • Giuseppe Bertozzi

    (Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, 71122 Foggia, Italy)

  • Gianpietro Volonnino

    (Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy)

  • Maria Nasso

    (Nuova Itor, Clinica accreditata, 00158 Rome, Italy)

  • Raffaele La Russa

    (Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, 71122 Foggia, Italy)

Abstract

Introduction: 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). Materials and Methods: 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. Results and Discussion: 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. Conclusion: The FMEA method can help identify anticoagulant therapy perioperative failures and implement the management and patient safety of surgical procedures.

Suggested Citation

  • Fausta Micheletta & Michela Ferrara & Giuseppe Bertozzi & Gianpietro Volonnino & Maria Nasso & Raffaele La Russa, 2022. "Proactive Risk Assessment through Failure Mode and Effect Analysis (FMEA) for Perioperative Management Model of Oral Anticoagulant Therapy: A Pilot Project," IJERPH, MDPI, vol. 19(24), pages 1-9, December.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:24:p:16430-:d:996722
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    References listed on IDEAS

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    1. Andrea Piccioni & Sara Cicchinelli & Luisa Saviano & Emanuele Gilardi & Christian Zanza & Mattia Brigida & Gianluca Tullo & Gianpietro Volonnino & Marcello Covino & Francesco Franceschi & Raffaele La , 2020. "Risk Management in First Aid for Acute Drug Intoxication," IJERPH, MDPI, vol. 17(21), pages 1-14, October.
    2. Christian Zanza & Fabrizio Racca & Yaroslava Longhitano & Andrea Piccioni & Francesco Franceschi & Marco Artico & Ludovico Abenavoli & Aniello Maiese & Giovanna Passaro & Gianpietro Volonnino & Raffae, 2021. "Risk Management and Treatment of Coagulation Disorders Related to COVID-19 Infection," IJERPH, MDPI, vol. 18(3), pages 1-16, January.
    3. Raffaele La Russa & Stefano Ferracuti, 2022. "Clinical Risk Management: As Modern Tool for Prevention and Management of Care and Prevention Occupational Risk," IJERPH, MDPI, vol. 19(2), pages 1-2, January.
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