C489 SAT1: Task 2 –FMEA Table
Likelihood Likelihood Severity Risk Priority
List 4 steps in List 1 Failure Mode per step of of Detection (1–10) Number
your Occurrence (1–10) (RPN)
Improvement Plan Process (1–10)
Example: On-call staff On-call staff forget to clock 4 5 2 40
must clock in within 30 in when arriving to the unit.
minutes of being notified.
1. Provide annual hospital RN’s and physicians do 5 3 10 150
policy education/training to not attend
RN’s/physicians providing education/training
moderate conscious sedation annually
to cover selected medications
and acceptable dosing.
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
Likelihood Likelihood Severity Risk Priority
List 4 steps in List 1 Failure Mode per step of of Detection (1–10) Number
your Occurrence (1–10) (RPN)
Improvement Plan Process (1–10)
Example: On-call staff On-call staff forget to clock 4 5 2 40
must clock in within 30 in when arriving to the unit.
minutes of being notified.
1. Provide annual hospital RN’s and physicians do 5 3 10 150
policy education/training to not attend
RN’s/physicians providing education/training
moderate conscious sedation annually
to cover selected medications
and acceptable dosing.
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
