Intravitreal injections: a healthcare failure modes and effects analysis.

Purpose: To perform a risk mitigation review of intravitreal injections. Methods: A pan-European expert team conducted a healthcare failure modes and effects analysis (HFMEA) of intravitreal injection techniques. Possible failures at each stage were identified and potential causes and effects considered. A risk value (1-10) was assigned for each failure's severity, probability of occurrence and likelihood of going undetected, and a risk priority number (RPN) calculated. Results: This HFMEA revealed 91 intravitreal injection failure modes, of which 28, deemed to have an appreciable risk, were explored. Recommendations were proposed to reduce these risks, mostly relating to patient, staff, room and equipment preparation, injection procedure and patient discharge. Conclusions: The HFMEA process produced practical recommendations to improve the risk profile of intravitreal injection. (C) 2013 S. Karger AG, Basel