Proactive risk assessment and nursing risk management in chemotherapy drugs: FMECA methodology results

The study aims to proactively analyze the chemotherapy drug management process, focusing on the nursing role: identifying error modes and proposing improvement interventions. A quality improvement project was conducted at an Onco-Hematological Department, applying a systematic and prospective approach to evaluate the critical phases of the chemotherapy drug process. A risk analysis was conducted using Failure Mode, Effects, and Criticality Analysis (FMECA). A multidisciplinary team of healthcare professionals with experience in the sector mapped the process, identified potential failure modes, calculated the Risk Priority Numbers (RPNs), and implemented corrective actions. The RPNs were re-evaluated after three months to measure intervention effectiveness. The analysis identified eight error modes, two of which were classified as high risk: contamination (initial RPN 27) and inaccurate dosing (initial RPN 24). After the implementation of improvement actions, such as specific training and formalized double checking, the RPNs were reduced to 4 and 3, respectively, with an improvement greater than 85%. The application of FMECA has allowed for effective identification and mitigation of the main risks associated with chemotherapeutic drug management, contributing to improve patient safety and nurse perceived quality of performance, through a model replicable in other healthcare settings.