Work

Mapping Failure Mode and Effects Analysis and Other Prospective Risk Analysis Approaches in Intrahospital Transport Involving Critically Ill Patients: A Scoping Review

Year: 2026

Type: article

Abstract: Intrahospital transport exposes critically ill patients and their care teams to clinical and organizational vulnerabilities, and proactive risk analysis can inform preventive interventions.This scoping review mapped the use of failure mode and effects analysis (FMEA), its variants, and complementary prospective risk analysis approaches in intrahospital transport pathways involving critically ill patients or critical care transitions.Studies of multi-area transfers, imaging pathways, and mixed adult and pediatric populations were included for their organizational relevance, not because all participants were critically ill.The review followed the Joanna Briggs Institute (JBI) methodology and was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science, and the Cochrane Library were searched on October 3, 2026, for studies published from 2002 to 2026.Three reviewers independently screened all records and full-text reports.All included studies were appraised with the Mixed Methods Appraisal Tool (MMAT) 2018, and the six studies with quantitative comparisons were also appraised with the JBI checklist for quasi-experimental studies.Of the 789 records identified, 689 were screened after the removal of 100 duplicates.Fourteen studies, reported in 15 publications, were included.Seven studies used FMEA, five used healthcare failure mode and effects analysis (HFMEA), and one used failure modes, effects and criticality analysis (FMECA); the remaining study used the bow-tie model.Recurring vulnerabilities involved communication and handoff, patient identification, medication management, equipment readiness, device security, and monitoring.Four studies reported fewer adverse events after implementation, one reported improved perceived preparedness, and one reported a lower risk priority number (RPN).Designs and outcomes were heterogeneous.The mapping can inform local risk analysis and the design of interventions, but the reported associations do not establish causal effectiveness.Controlled multicenter evaluations with measures of fidelity, sustainability, and cost are needed.The vulnerabilities and preventive strategies identified are particularly relevant to nursing practice, given the central role of nurses in patient preparation, monitoring, device protection, medication continuity, and interprofessional handoff.No dedicated studies have addressed transport from the intensive care unit or emergency department to the operating room or between intensive care units, and research is needed in underrepresented regions, such as the Middle East, Southeast Asia, Latin America, and most of Europe.

Source: Cureus

DOI: 10.7759/cureus.119291