Effects of Healthcare Failure Mode and Effect Analysis on the Prevention of Deep Venous Thrombosis in Elderly Patients Undergoing Femoral Fracture Surgery
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Keywords

Healthcare failure mode and effect analysis
Venous thrombosis
Femoral fracture

DOI

10.26689/jcnr.v9i6.10978

Submitted : 2025-06-04
Accepted : 2025-06-19
Published : 2025-07-04

Abstract

Purpose: To evaluate the effects of healthcare failure mode and effect analysis (FMEA) on the prevention of deep venous thrombosis (DVT) in elderly patients undergoing femoral fracture surgery. Methods: Eighty elderly patients undergoing femoral fracture surgery who did not apply FMEA in Suzhou BenQ Medical Center from June 1, 2022 to May 31, 2023 were selected as the control group. According to the equal group experiment method, 80 elderly patients who were managed using FMEA from June 1, 2023 to May 31, 2024 were selected as the FMEA group. The control group received traditional nursing management, while the FMEA group applied FMEA to analyze failure causes, calculate Risk Priority Numbers (RPNs), identify failure modes with higher RPNs, analyze the influencing factors, develop improvement measures, and optimize processes. The RPN values and the incidence of DVT, as well as nursing satisfaction scores, were compared in the two groups. Results: Compared with the control group, the total RPN values of the FEMA group decreased significantly, with a reduction rate of 87.0%. Besides, the incidence of DVT was 1.3% in the FMEA group, lower than 10.0% in the control group (8/80). What’s more, the patients in the FMEA group were more satisfied with the nursing service compared with the patients in the control group. Conclusion: The application of the FMEA in elderly patients undergoing femoral fracture surgery has demonstrated its potential to prevent the incidence of DVT, lower RPN values, and improve nursing satisfaction.

References

Navarrete S, Solar C, Tapia R, et al., 2023, Pathophysiology of Deep Vein Thrombosis. Clin Exp Med, 23(3): 645–654.

Ortel TL, Neumann I, Ageno W, et al., 2020, American Society of Hematology 2020 Guidelines for Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolism. Blood Adv, 4(19): 4693–4738.

Jones A, Al-Horani RA, 2023, Venous Thromboembolism Prophylaxis in Major Orthopedic Surgeries and Factor XIa Inhibitors. Med Sci (Basel), 11(3): 49.

American Society for Healthcare Risk M, 2002, Strategies and Tips for Maximizing Failure Mode and Effect Analysis in an Organization. J Healthc Risk Manag, 22(3): 9–12.

Ouellette-Piazzo K, Asfaw B, Cowen J, 2007, CT Healthcare Failure Mode Effect Analysis (HFMEA): The Misadministration of IV Contrast in Outpatients. Radiol Manage, 29(1): 36–44; quiz 45–47.

Lijoi D, Farina M, Puppo A, et al., 2019, Application of Failure Mode and Effect Analysis in Total Laparoscopic Hysterectomy in Benign Conditions. Minerva Ginecol, 71(4): 272–280.

Chopard R, Albertsen IE, Piazza G, 2020, Diagnosis and Treatment of Lower Extremity Venous Thromboembolism: A Review. JAMA, 324(17): 1765–1776.

Autar R, 1996, Nursing Assessment of Clients at Risk of Deep Vein Thrombosis (DVT): The Autar DVT Scale. J Adv Nurs, 23(4): 763–770.

Li T, Li J, Yuan L, et al., 2022, Effect of Regional vs General Anesthesia on Incidence of Postoperative Delirium in Older Patients Undergoing Hip Fracture Surgery: The RAGA Randomized Trial. JAMA, 327(1): 50–58.

Guo H, Xu K, Deng F, et al., 2024, Risk Prediction Models for Preoperative Deep Vein Thrombosis in Older Patients With Hip Fracture: A Systematic Review and Meta-Analysis. Clin Appl Thromb Hemost, 30: 10760296241285565.

Bengoa F, Vicencio G, Schweitzer D, et al., 2020, High Prevalence of Deep Vein Thrombosis in Elderly Hip Fracture Patients With Delayed Hospital Admission. Eur J Trauma Emerg Surg, 46(4): 913–917.

Liu HC, Zhang LJ, Ping YJ, et al., 2020, Failure Mode and Effects Analysis for Proactive Healthcare Risk Evaluation: A Systematic Literature Review. J Eval Clin Pract, 26(4): 1320–1337.

Xu Y, Wang W, Li Z, et al., 2021, Effects of Healthcare Failure Mode and Effect Analysis on the Prevention of Multi-Drug Resistant Organism Infections in Oral and Maxillofacial Surgery. Am J Transl Res, 13(4): 3674–3681.

Yang Y, 2024, Impact of FMEA-Based Nursing on Postoperative Condition of Appendicitis Patients. Altern Ther Health Med, 31(1): 343–347.

Lin L, Wang R, Chen T, et al., 2021, Failure Mode and Effects Analysis on the Control Effect of Multi-Drug-Resistant Bacteria in ICU Patients. Am J Transl Res, 13(9): 10777–10784.