C489 SAT1: Task 2 –FMEA Table
List 4 steps in
your
Improvement Plan Process
List 1 Failure Mode per step
Likelihood
of
Occurrence
(1–10)
Likelihood
of Detection
(1–10)
Severity
(1–10)
Risk Priority
Number
(RPN)
Example: On-call staff
must clock in within 30
minutes of being notified.
On-call staff forget to clock
in when arriving to the unit.
4 5 2 40
1. Provide annual hospital
policy education/training to
RN’s/physicians providing
moderate conscious sedation
to cover selected medications
and acceptable dosing.
RN’s and physicians do
not attend
education/training
annually
5 3 10 150
2. Providing a moderate Moderate conscious 5 8 10 400
conscious sedation checklist for sedation checklist is not
every procedure to include provided for every
medications with their reversal, procedure.
respirations, equipment
needed such as a blood
pressure/ECG monitor and a
pulse oximeter with vital signs
every 15 minutes
3. Policies in place for staff to Staff patient ratio policy not 3 9 9 243
patient ratios which would be available for staff to review
an indicator for when when additional staff is
additional staff are needed needed.
preventing the staff from being
overwhelmed.
4. Clinical education needs to LPN’s are not provided 4 3 9 108
