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2SPD-012 Application of failure mode and effects analysis to improve automated dispensing cabinets’ drug stock management processes
  1. M Fernández González,
  2. HL Acosta García,
  3. P Suárez Casillas,
  4. JL Pérez Blanco,
  5. JP Quintero García,
  6. MV Gil Navarro
  1. Hospital Universitario Virgen del Rocío, Pharmacy, Sevilla, Spain


Background and Importance Logistics processes for drug stock management are critical in the organisation of pharmacy services. Automated dispensing cabinets (ADCs) allow for better control of these processes, increasing patient safety, optimising drug consumption and costs. However, the use of these devices is not always the most appropriate, compromising its advantages.

Aim and Objectives To carry out a failure mode and effects analysis (FMEA) to optimise the use of ADCs by all stakeholders (pharmacists, pharmacy technicians and nurses).

Material and Methods A multidisciplinary team was established to perform an analysis using FMEA methodology (pharmacists, nurses, and pharmacy technicians). They defined all related failure modes that could occur, indicating causes and consequences through brainstorming meetings. Five risk maps were performed on the following processes: Resupply of ADCs, in floor return of drugs to ADCs, restock of temporary transfer cabinets, review of drugs expiration date, and drug dispensing through ADCs. The risk priority number (RPN) was calculated according to the following indices: Severity x Frequency x Detectability, assigning values from 1 to 10 to each index. Median RPN values were used to prioritise. Preventive and corrective actions were proposed.

Results A total of 27 failure modes were defined, accumulating 3,553 points of RPN (values ranged 9–300). The process ‘drug dispensing through ADCs’ obtained the highest median RPN value (192, 126–246). The number of failure modes with a RPN >200 was 6. After prioritisation, an action plan consisting of several activities, based on good practices guidelines from the Institute for Safe Medication Practices (ISMP) was proposed. A training programme for nurses on the use of ADCs was designed and implemented to ensure correct use on the hospitalisation floor. A reception plan for new pharmacy technicians, consisting of training documents, was elaborated. Finally, a plan for ADCs’ setup and regular stock review by specialist pharmacists was designed. After 6 months, a new analysis was performed, and all the failure modes evaluated scored a RPN value <200.

Conclusion and Relevance The FMEA methodology allowed us to detect and evaluate failure modes and its effects, implementing an action plan to optimise the use of ADCs. In the future, a survey among sanitary professionals will be carried out to analyse the impact of these actions.

Conflict of Interest No conflict of interest.

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