Journal of Advanced in Medicinal, Pharmaceutical and Biomedical Research (JAMPBR)

Abstract This study applies Failure Mode and Effects Analysis (FMEA) to assess and mitigate risks in key hospital departments, aiming to enhance patient safety and process reliability. Conducted in a 400-bed tertiary hospital over a six-month period, the research focused on three high-risk units: the Intensive Care Unit (ICU), Operating Room (OR), and Pharmacy. Data were collected through incident reports, structured interviews, and process observations. For each failure mode, the Risk Priority Number (RPN) was calculated based on severity, occurrence, and detectability scores. In the ICU, alarm fatigue had the highest RPN (336), signaling a critical need for smarter alarm systems. In the OR, incomplete time-out procedures posed the greatest risk (RPN: 315), highlighting communication gaps. In the Pharmacy, look-alike/sound-alike (LASA) medications were the most dangerous (RPN: 336), indicating the importance of system-based labeling and verification strategies. The study concludes that FMEA is a practical, data-driven approach for identifying latent hazards in hospital systems. Targeted interventions such as staff training, digital checklists, and barcode medication administration systems are recommended. Integrating FMEA with hospital information systems and routine quality audits can significantly improve patient safety outcomes and organizational resilience.

Abstract Introduction: The investigation of vitamin C supplementation in reducing postoperative complications after cardiac surgery holds significant clinical relevance, given the persistent morbidity, prolonged recovery, and increased healthcare costs linked to such adverse events. By targeting oxidative stress and inflammation—central mechanisms underlying many postoperative complications—vitamin C may provide a simple, cost-effective adjunct to current perioperative management, potentially improving patient outcomes and optimizing resource utilization in cardiac surgical care.

Material and methods: This prospective, randomized, double-blind, placebo-controlled trial evaluated the effect of perioperative vitamin C supplementation on postoperative complications in adult patients undergoing elective cardiac surgery with cardiopulmonary bypass. Eligible patients were recruited consecutively, randomized via sealed envelopes, and given either vitamin C or placebo in a blinded fashion. Data analysis followed intention-to-treat principles, and ethical approval and informed consent were obtained for all participants, ensuring rigor and patient safety throughout the study.

Results: This comparative table highlights that postoperative delirium in cardiac surgery patients is significantly associated with several adverse clinical factors. Patients with delirium had lower LVEF, longer operation and cardiopulmonary bypass (CPB) durations, greater bleeding volume, extended mechanical ventilation, and prolonged ICU stays, all with highly significant p-values.

Conclusion: this study confirms that delirium affects a substantial proportion of cardiac surgery patients and is closely associated with multiple markers of cardiac dysfunction, surgical complexity, and postoperative instability.