A New Risk Assessment Methodology Based on Control Limits

Year 2025, Volume: 29 Issue: 2, 226 - 239

Müfide Narlı , Şeyda Taşkınırmak , Cansu Dağsuyu , Ali Kokangül

https://doi.org/10.16984/saufenbilder.1585752

Abstract

Operating rooms where surgical procedures are conducted involve hazards under various groups and potentially many health problems may arise from these hazards. The degree of the importance of the hazard in each risk group varies according to the groups and it is important to reflect this situation in the risk analyses. In the present study, the dangers may occur in the main groups, namely physical, chemical, and psychological hazard groups in the operating rooms, and the potential health problems that may result from these hazards were evaluated with Failure Mode Effect Analysis (FMEA) method for the first time. By taking the distribution of the FMEA values about the health problems due to hazards that may occur in each main group into consideration, a new approach is suggested in this study. With the new scale that is created based on the average and standard deviation of FMEA values, the comparative importance of the hazards within their groups was revealed. Thus, considering the comparative evaluations, the degrees of importance for health problems in terms of physical, chemical, psychological, and biological categorization were put forth. The COVID-19 outbreak caused a pandemic in the world was also considered in the biological risk class in the study. At the end of the study, the most critical health problems in the operating rooms were detected to be from the risk group resulting from chemical conditions.

Keywords

Operating room, Risk analysis, FMEA, Control limits

Ethical Statement

The study does not require an ethical declaration, permission has been obtained for the data. The data will be shared when requested.

Supporting Institution

No supporting institution

Thanks

In this study, we offer our thanks to Professor of Cukurova University Anestesiology Department , Dr Yasemin Güneş and Pediatric Surgeon works in a special hospital Dr Mesut Koca.

References

• A. Sheikhzadeh, C. Gore, J.D. Zuckerman, M. Nordin, “Perioperating nurses and technicians perceptions of ergonomic risk factors in the surgical environment,” Applied ergonomics, 40(5), 833-839, 2009.
• D. Yu, B. Lowndes, C. Thiels, J. Bingener, A. Abdelrahman, R. Lyons, S. Hallbeck, “Quantifying intraoperative workloads across the surgical team roles: Room for better balance?,” World journal of surgery, 40(7), 1565-1574, 2016.
• F. Vural, E. Sutsunbuloglu. “Ergonomics: an important factor in the operating room,” Journal of perioperative practice, 26(7-8), 174-178, 2016.
• N. Rafter, A. Hickey, S. Condell, R. Conroy, P. O’Connor, D. Vaughan, D. Williams, “Adverse events in healthcare: learning from mistakes,” QJM, 108(4), 273–277. 2014.
• L.T. Kohn, J. M. Corrigan, M. S. Donaldson. To Err Is Human: Building a Safer Health System, National Academies Press, 2000.
• D. Gupta, “Surgical Suites’ Operations Management,” Production and Operations Management, 16(6), 689–700, 2009.
• U. Matern, S. Koneczny, “Safety, hazards and ergonomics in the operating room,” Surgical endoscopy, 21(11), 1965-1969, 2007.
• R. Khasha, M. M. Sepehri, T. Khatibi, T, “A fuzzy FMEA approach to prioritizing surgical cancellation factors,” International Journal of Hospital Research, 2(1), 17-24, 2013.
• L. Pan, S. Tan, L. Cao, X. Feng, “Risk factor analysis and management strategies of operating room-related infections after coronary artery bypass grafting,” Journal of thoracic disease, 10(8), 4949, 2018.
• G. Abo El Ata, S. El Desouky, M. Manawil, E. Khalifa, “Assessment of work-related musculoskeletal symptoms in operation room nurses,” Curr Sci Int, 5(2), 215-22, 2016.
• R. K. Voss, Y. J. Chiang, K. D. Cromwell, D.L. Urbauer, J. E. Lee, J. N. Cormier, C.C. H. Stucky, C. C. H. “Do no harm, except to ourselves? A survey of symptoms and injuries in oncologic surgeons and pilot study of an intraoperative ergonomic intervention,” Journal of the American College of Surgeons, 224(1), 16-25, 2017.
• S. H. Ho, L. Rosario, M. M. Rahman, “Three-dimensional analysis for hospital operating room thermal comfort and contaminant removal,” Applied Thermal Engineering, 29(10), 2080-2092, 2009.
• E. G. Dascalaki, A. G. Gaglia, C. A. Balaras, A. Lagoudi, “Indoor environmental quality in Hellenic hospital operating rooms,” Energy and Buildings, 41(5), 551-560, 2009.
• C. S. Rinder, “Fire safety in the operating room,” Current Opinion in Anesthesiology, 21(6), 790-795, 2008.
• W. C. Culp, B.A. Kimbrough, S. Luna, “Flammability of surgical drapes and materials in varying concentrations of oxygen,” Anesthesiology: The Journal of the American Society of Anesthesiologists, 119(4), 770-776, 2013.
• J. W. Senders, “FMEA and RCA: the mantras; of modern risk management,” BMJ Quality & Safety, 13(4), 249-250, 2004.
• B. Mosallanezhad, “Using fuzzy FMEA to increase patient safety in fundamental processes of operating room,” Journal of Industrial and Systems Engineering, 11(3), 146-166, 2018.
• H. C. Liu, J. X. You, X. Y. You, “Evaluating the risk of healthcare failure modes using interval 2-tuple hybrid weighted distance measure,” Computers & Industrial Engineering, 78, 249-258, 2014.
• P. Trucco, M. Cavallin, “A quantitative approach to clinical risk assessment: The CREA method,” Safety science, 44(6), 491-513, 2006.
• L. Guo, “Implementation of a risk management plan in a hospital operating room”, International Journal of Nursing Sciences, 2(4), 348-354, 2015.
• N. Kasatpibal, J. D. Whitney, S. Katechanok, S. Ngamsakulrat, B. Malairungsakul, P. Sirikulsathean, T. Muangnart, “Prevalence and risk factors of needlestick injuries, sharps injuries, and blood and body fluid exposures among operating room nurses in Thailand,” American journal of infection control, 44(1), 85-90, 2016.
• M. Amghar, B. Zoulloutı, N. Sbıtı, “Risk analysis of operating room using the fuzzy bayesian network model,” International Journal of Engineering, 30(1), 66-74, 2017.
• Institute for Healthcare Improvement (Access date: April 1, 2025). Patient safety essentials toolkit: Failure Modes and Effects Analysis (FMEA) tool [Online]. Available: https://www.ihi.org/sites/default/files/SafetyToolkit_FailureModesandEffectsAnalysis.pdf
• D. H. Stamatis, “Failure mode and effect analysis: FMEA from theory to execution. Quality Press,” 2003.
• Alemdağ, M. Ameliyathanede Çalışan Sağlık Personelinin Sağlığı Geliştirici Yaşam Biçimi Davranışları ve İlişkili Faktörlerin Belirlenmesi (Doctoral dissertation, Ankara Yıldırım Beyazıt Üniversitesi Sağlık Bilimleri Enstitüsü), 2019.
• R. Van Gaever, V. A Jacobs, M. Diltoer, L. Peeters, S. Vanlanduit, “Thermal comfort of the surgical staff in the operating room,” Building and Environment, 81, 37-41, 2014.
• M Lembo, V. Cannatà, A. Militello, M. Ritrovato, S. Zaffina, P. Derrico, M Borra, “Artificial lighting and blue light in the operating room: What risks for the surgeon,” La Medicina del lavoro, 106(5), 342-350, 2015.
• S. Q. Wilburn, G. Eijkemans, “Preventing needlestick injuries among healthcare workers: A WHO–ICN Collaboration,” International Journal of Occupational and Environmental Health, 10: 451–456, 2004.
• M. S. Spoorthy, S. K. Pratapa, S. Mahant, “Mental health problems faced by healthcare workers due to the COVID-19 pandemic–A review,” Asian Journal of Psychiatry, 51, 102119, 2020.
• S. Reddy, R. Manuel, E. Sheridan, G. Sadler, S. Patel, P. Riley, P, “Brucellosis in the UK: A Risk to Laboratory Workers? Recommendations For Prevention and Management of Laboratory Exposure,” J. Clin Pathol, 63, 90-92, 2010.
• S. Hoşoğlu, A. Ç. Tanrıkulu, C. Dağlı, Ş. Akalın Ş “Bir Üniversite Hastanesinin Çalışanlarında Tüberküloz Riski,” Toraks Dergisi, 5(3): 196-200, 2004.
• A. S. Karaca, M. M. Özmen, A. D. Uçar, A. Ç. Yastı, S. Demirer, “COVID-19’lu hastalarda genel cerrahi ameliyathane uygulamaları,” Turk J Surg, 36(1), 6-10, 2020.
• R. Pan, L. Zhang, J. Pan, “The Anxiety Status of Chinese Medical Workers During the Epidemic of COVID19: A Meta-Analysis”, Psychiatry investigation, 17(5), 475–480, 2020.