Background and importance Drug stock management is a complex process because space, budget and other external factors such as delivery delays or demand variability must be taken into account. To manage a drug stock properly is a pharmacist’s responsibility.

Aim and objectives To carry out a failure mode and effect modal analysis (FMEA) in the cytostatic drug store to improve the stock management process.

Material and methods A multidisciplinary team was assembled to perform the detection of failure modes and their causes through FMEA methodology. Then, risk priority index (RPI) was calculated: frequency (F) × severity (G) × detectability (D), assigning values from 1 to 5 to each factor. Finally, corrective measures for risks were suggested.

Results Risk map was performed with the following subprocesses: realisation of the order with drugs whose stock is below the alert stock, selection of the drug presentation considering the dose for better utilisation, elaboration and administration.

Failure modes:

1. Delay in ordering medication: F:5 G:5 D:5, RPI:125.

2. Non–matching used drug presentation with the drug registered in the computer system: F:1 G:5 D:5, RPI:25.

3. Waste of remaining quantities of not used drug that day: F:3 G:1 D:3, RPI:9.

4. Issue administration on scheduled day and return to pharmacy: F:1 G:1 D:4, RPI:4.

Causes:

1. Unclaimed pending order.

2. Wrong choice of drug presentation during the preparation.

3. Lack of knowledge by the nursing staff about the stability of the vials once opened.

4. Poor day hospital−pharmacy communication flow in terms of real–time patient appointments.

Proposed actions:

1. Training sessions for nurses, orderlies and administrative staff.

2. Validation checklist implementation in the process of preparing.

3. Development of a list of drug stability once opened.

4. Real–time confirmation by day hospital of patient attendance at appointments.

Realisation of the order with drugs whose stock is below the alert stock was the subprocess with the highest number of failure modes. Delayed medication order was the failure mode with the highest RPI.

Conclusion and relevance The FMEA methodology allowed us to detect failure modes and their causes in order to redefine a process to improve its quality. Stock management process is a key element and we learned that more frequent training sessions for Pharmacy Department staff and monitoring actual stock in an exhaustive way are needed.

Conflict of interest No conflict of interest