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Year 2025, Volume: 29 Issue: 5, 1994 - 2007, 01.09.2025
https://doi.org/10.12991/jrespharm.1764962

Abstract

References

  • [1] Ssekitoleko RT, Oshabaheebwa S, Munabi IG, Tusabe MS, Namayega C, Ngabirano BA, et al. The role of medical equipment in the spread of nosocomial infections: A cross-sectional study in four tertiary public health facilities in Uganda. BMC Public Health. 2020;20(1):1561 https://doi.org/10.1186/s12889-020-09662-w
  • [2] Garvey M. Medical device-associated healthcare ınfections: sterilization and the potential of novel biological approaches to ensure patient safety. Int J Mol Sci. 2023;25(1):201.https://doi.org/10.3390/ijms25010201
  • [3] Rutala WA, Weber DJ. Disinfection, Sterilization, and Control of Hospital Waste. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 2015. p. 3294-3309.e4 https://doi.org/10.1016/B978-1-4557-4801- 3.00301-5
  • [4] Josephs-Spaulding J, Singh O V. Medical device sterilization and reprocessing in the era of Multidrug-Resistant (MDR) Bacteria: Issues and regulatory concepts. Front Med Technol. 2020;2:587352 https://doi.org/10.3389/fmedt.2020.587352
  • [5] Cheikh MHB, Teka M, Fhal M, Zribi K, Majdoub A. Mise en place d´un système de management de la qualité dans une unité de stérilisation centralisée: expérience de l´Hôpital Tahar Sfar de Mahdia en Tunisie [Implementation of a quality management system in a central sterilization unit: experience in the Hospital Tahar Sfar, Mahdia, Tunisia]. Pan Afr Med J. 2021;39:287. https://doi.org/10.11604/pamj.2021.39.287.25653.
  • [6] Panta G, Richardson AK, Shaw IC, Coope PA. Compliance of primary and secondary care public hospitals with standard practices for reprocessing and steam sterilization of reusable medical devices in Nepal: Findings from nation-wide multicenter clustered audits. BMC Health Serv Res. 2020;20(1):923 https://doi.org/10.1186/s12913-020- 05788-0.
  • [7] Maurin A, Petit A, Tilleul P, Combeau D. Certification ISO 9001 d’un service de stérilisation : passage à la version 2015 [ISO 9001 certification of a sterilization unit: Transition to the 2015 version]. Ann Pharm Fr. 2019;77(5):363-373. French. https://doi.org/10.1016/j.pharma.2019.05.002
  • [8] Trouillard A, Gillois A, Tournayre V, Barrans MA, Boix S, Vidal JR. [ISO 9001 quality approach in Sterilization Unit and developing the skills of agents: Contribution of a multi-support, transdisciplinary and multi-professional training plan]. Ann Pharm Fr. 2022;80(1):67–75 https://doi.org/10.1016/j.pharma.2021.04.004
  • [9] Mustapha L, Lebel C, Boddaert S, Castelain S, Duverlie G, Ganry O, Herpe YÉ, Lebreton S, Marolleau JP, Sevestre H, Soriot-Thomas S, Tebbakha R, Yzet T, Sautier A, Schmit JL. Certification ISO 9001 : 2015 de l’ensemble des activités de recherche d’un centre hospitalier universitaire [ISO 9001: 2015 certification of all research activities of a university hospital center]. Therapie. 2023;78(6):721-732. French.
  • [10] Kammoun A, Hachicha W, Aljuaid AM. Integrating Quality Tools and Methods to Analyze and Improve a Hospital Sterilization Process. Healthcare (Basel). 2021;9(5):544. https://doi.org/10.3390/healthcare9050544
  • [11] Poli M, Quaglierini M, Zega A, Pardini S, Telleschi M, Iervasi G, Guiducci L. Risk Management in Good Manufacturing Practice (GMP) Radiopharmaceutical Preparations. Appl Sci. 2024;14(4) : 1584. https://doi.org/10.3390/app14041584
  • [12] Wyss UP. Improving the Quality of Life of Patients With Medical Devices by a Timely Analysis of Adverse Events. Front Med. 2019;6:56 https://doi.org/10.3389/fmed.2019.00056
  • [13] Chen YJ, Chiou CM, Huang YW, Tu PW, Lee YC, Chien CH. A Comparative Study of Medical Device Regulations:: US, Europe, Canada, and Taiwan. Ther Innov Regul Sci. 2018;52(1):62–69 https://doi.org/10.1177/2168479017716712
  • [14] McEvoy B, Rowan NJ. Terminal sterilization of medical devices using vaporized hydrogen peroxide: a review of current methods and emerging opportunities. J Appl Microbiol. 2019;127(5):1403–1420 https://doi.org/10.1111/jam.14412
  • [15] Ashley L, Armitage G, Neary M, Hollingsworth G. A Practical Guide to Failure Mode and Effects Analysis in Health Care: Making the Most of the Team and Its Meetings. Jt Comm J Qual Patient Saf. 2010;36:351–358 https://doi.org/10.1016/S1553-7250(10)36053-3
  • [16] Rath F. Tools for developing a quality management program: proactive tools (process mapping, value stream mapping, fault tree analysis, and failure mode and effects analysis). Int J Radiat Oncol Biol Phys. 2008;71(1 Suppl):S187-190 https://doi.org/10.1016/j.ijrobp.2007.07.2385
  • [17] Caldwell BS. Tools for developing a quality management program: human factors and systems engineering tools. Int J Radiat Oncol Biol Phys. 2008;71(1 Suppl):S191-194 https://doi.org/10.1016/j.ijrobp.2007.06.083
  • [18] Liu HC, You XY, Tsung F, Ji P. An improved approach for failure mode and effect analysis involving large group of experts: An application to the healthcare field. Qual Eng. 2018;30:1–44 https://doi.org/10.1080/08982112.2018.1448089
  • [19] Sobral J, Teixeira D, Morais H, Neves M. Methodology to assess medical processes based on a Failure Mode and Effects Analysis (FMEA). In: 2017 IEEE 5th Portuguese Meeting on Bioengineering (ENBENG), pp. 1–4 https://doi.org/10.1016/j.heliyon.2022.e08944
  • [20] El-Awady SMM. Overview of Failure Mode and Effects Analysis (FMEA): A Patient Safety Tool. Glob J Qual Saf Healthc. 2023;6(1):24–26 https://doi.org/10.36401/JQSH-23-X2
  • [21] Harris S, Nino V, Claudio D. Simulating a sterilization processing department to evaluate block schedules and tray configurations. Syst Eng. 2024;27(1):54–73 https://doi.org/10.1016/j.heliyon.2022.e08944
  • [22] Jildeh ZB, Wagner PH, Schöning MJ. Sterilization of objects, products, and packaging surfaces and their characterization in different fields of ındustry: The Status in 2020. Phys status solidi. 2021;218(13):2000732 https://doi.org/10.1002/pssa.202000732
  • [23] Mascia A, Cirafici AM, Bongiovanni A, Colotti G, Lacerra G, Di Carlo M, et al. A failure mode and effect analysis (FMEA)-based approach for risk assessment of scientific processes in non-regulated research laboratories. Accredit Qual Assur. 2020;25(5):311–321 https://doi.org/10.1007/s00769-020-01441-9
  • [24] Subriadi AP, Najwa NF. The consistency analysis of failure mode and effect analysis (FMEA) in information technology risk assessment. Heliyon. 2020;6(1):e03161 https://doi.org/10.1016/j.heliyon.2020.e03161
  • [25] Mardani Shahri M, Eshraghniaye Jahromi A, Houshmand M. Failure Mode and Effect Analysis using an integrated approach of clustering and MCDM under pythagorean fuzzy environment. J Loss Prev Process Ind. 2021;72:104591 https://doi.org/10.1016/j.jlp.2021.104591
  • [26] Panta G, Richardson AK, Shaw IC, Chambers S, Coope PA. Effectiveness of steam sterilization of reusable medical devices in primary and secondary care public hospitals in Nepal and factors associated with ineffective sterilization: A nation-wide cross-sectional study. PLoS One. 2019;14(11):e0225595 https://doi.org/10.1371/journal.pone.0225595
  • [27] Selvik JT, Signoret JP. How to interpret safety critical failures in risk and reliability assessments. Reliab Eng Syst Saf. 2017;161:61–68 https://doi.org/10.1016/j.ress.2017.01.003
  • [28] Bowles J. An Assessment of RPN Prioritization in a Failure Modes Effects and Criticality Analysis. J IEST. 2003; 47: 380–386 . https://doi.org/10.17764/jiet.47.1.y576m26127157313.

Risk management in the sterilization process for reusable medical devices: Moroccan Hospital experience

Year 2025, Volume: 29 Issue: 5, 1994 - 2007, 01.09.2025
https://doi.org/10.12991/jrespharm.1764962

Abstract

In the hospital environment, risk mapping aims to identify and assess the criticality of potential risks associated with each stage in the sterilization process for reusable medical devices (RMDs). Our approach aims to develop preventive and corrective measures to better control these risks. From September to December 2023, an a priori risk analysis was carried out in the central sterilization unit of Rabat's specialized hospital. The methodology used will be based on the FMEA method (Failure Modes, Effects and Criticality Analysis), enabling a qualitative and quantitative analysis of risks. A total of 37 failure modes were identified during the sterilization process, including 20 minor criticality risks, 13 medium criticality risks and 4 major criticality risks. The highest number of failures occurred in the cleaning/disinfection and packaging stages, while the riskiest process was recomposition, with two unacceptable risks identified. Once the criticality had been assessed, corrective measures were proposed for all unacceptable risks likely to have a significant impact on the safety of patients and hospital staff. In light of the results, the working group was able to implement a number of preventive and curative measures, and communication remains a crucial element in ensuring compliance with the DMR and the safety of patients and medical staff.

References

  • [1] Ssekitoleko RT, Oshabaheebwa S, Munabi IG, Tusabe MS, Namayega C, Ngabirano BA, et al. The role of medical equipment in the spread of nosocomial infections: A cross-sectional study in four tertiary public health facilities in Uganda. BMC Public Health. 2020;20(1):1561 https://doi.org/10.1186/s12889-020-09662-w
  • [2] Garvey M. Medical device-associated healthcare ınfections: sterilization and the potential of novel biological approaches to ensure patient safety. Int J Mol Sci. 2023;25(1):201.https://doi.org/10.3390/ijms25010201
  • [3] Rutala WA, Weber DJ. Disinfection, Sterilization, and Control of Hospital Waste. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 2015. p. 3294-3309.e4 https://doi.org/10.1016/B978-1-4557-4801- 3.00301-5
  • [4] Josephs-Spaulding J, Singh O V. Medical device sterilization and reprocessing in the era of Multidrug-Resistant (MDR) Bacteria: Issues and regulatory concepts. Front Med Technol. 2020;2:587352 https://doi.org/10.3389/fmedt.2020.587352
  • [5] Cheikh MHB, Teka M, Fhal M, Zribi K, Majdoub A. Mise en place d´un système de management de la qualité dans une unité de stérilisation centralisée: expérience de l´Hôpital Tahar Sfar de Mahdia en Tunisie [Implementation of a quality management system in a central sterilization unit: experience in the Hospital Tahar Sfar, Mahdia, Tunisia]. Pan Afr Med J. 2021;39:287. https://doi.org/10.11604/pamj.2021.39.287.25653.
  • [6] Panta G, Richardson AK, Shaw IC, Coope PA. Compliance of primary and secondary care public hospitals with standard practices for reprocessing and steam sterilization of reusable medical devices in Nepal: Findings from nation-wide multicenter clustered audits. BMC Health Serv Res. 2020;20(1):923 https://doi.org/10.1186/s12913-020- 05788-0.
  • [7] Maurin A, Petit A, Tilleul P, Combeau D. Certification ISO 9001 d’un service de stérilisation : passage à la version 2015 [ISO 9001 certification of a sterilization unit: Transition to the 2015 version]. Ann Pharm Fr. 2019;77(5):363-373. French. https://doi.org/10.1016/j.pharma.2019.05.002
  • [8] Trouillard A, Gillois A, Tournayre V, Barrans MA, Boix S, Vidal JR. [ISO 9001 quality approach in Sterilization Unit and developing the skills of agents: Contribution of a multi-support, transdisciplinary and multi-professional training plan]. Ann Pharm Fr. 2022;80(1):67–75 https://doi.org/10.1016/j.pharma.2021.04.004
  • [9] Mustapha L, Lebel C, Boddaert S, Castelain S, Duverlie G, Ganry O, Herpe YÉ, Lebreton S, Marolleau JP, Sevestre H, Soriot-Thomas S, Tebbakha R, Yzet T, Sautier A, Schmit JL. Certification ISO 9001 : 2015 de l’ensemble des activités de recherche d’un centre hospitalier universitaire [ISO 9001: 2015 certification of all research activities of a university hospital center]. Therapie. 2023;78(6):721-732. French.
  • [10] Kammoun A, Hachicha W, Aljuaid AM. Integrating Quality Tools and Methods to Analyze and Improve a Hospital Sterilization Process. Healthcare (Basel). 2021;9(5):544. https://doi.org/10.3390/healthcare9050544
  • [11] Poli M, Quaglierini M, Zega A, Pardini S, Telleschi M, Iervasi G, Guiducci L. Risk Management in Good Manufacturing Practice (GMP) Radiopharmaceutical Preparations. Appl Sci. 2024;14(4) : 1584. https://doi.org/10.3390/app14041584
  • [12] Wyss UP. Improving the Quality of Life of Patients With Medical Devices by a Timely Analysis of Adverse Events. Front Med. 2019;6:56 https://doi.org/10.3389/fmed.2019.00056
  • [13] Chen YJ, Chiou CM, Huang YW, Tu PW, Lee YC, Chien CH. A Comparative Study of Medical Device Regulations:: US, Europe, Canada, and Taiwan. Ther Innov Regul Sci. 2018;52(1):62–69 https://doi.org/10.1177/2168479017716712
  • [14] McEvoy B, Rowan NJ. Terminal sterilization of medical devices using vaporized hydrogen peroxide: a review of current methods and emerging opportunities. J Appl Microbiol. 2019;127(5):1403–1420 https://doi.org/10.1111/jam.14412
  • [15] Ashley L, Armitage G, Neary M, Hollingsworth G. A Practical Guide to Failure Mode and Effects Analysis in Health Care: Making the Most of the Team and Its Meetings. Jt Comm J Qual Patient Saf. 2010;36:351–358 https://doi.org/10.1016/S1553-7250(10)36053-3
  • [16] Rath F. Tools for developing a quality management program: proactive tools (process mapping, value stream mapping, fault tree analysis, and failure mode and effects analysis). Int J Radiat Oncol Biol Phys. 2008;71(1 Suppl):S187-190 https://doi.org/10.1016/j.ijrobp.2007.07.2385
  • [17] Caldwell BS. Tools for developing a quality management program: human factors and systems engineering tools. Int J Radiat Oncol Biol Phys. 2008;71(1 Suppl):S191-194 https://doi.org/10.1016/j.ijrobp.2007.06.083
  • [18] Liu HC, You XY, Tsung F, Ji P. An improved approach for failure mode and effect analysis involving large group of experts: An application to the healthcare field. Qual Eng. 2018;30:1–44 https://doi.org/10.1080/08982112.2018.1448089
  • [19] Sobral J, Teixeira D, Morais H, Neves M. Methodology to assess medical processes based on a Failure Mode and Effects Analysis (FMEA). In: 2017 IEEE 5th Portuguese Meeting on Bioengineering (ENBENG), pp. 1–4 https://doi.org/10.1016/j.heliyon.2022.e08944
  • [20] El-Awady SMM. Overview of Failure Mode and Effects Analysis (FMEA): A Patient Safety Tool. Glob J Qual Saf Healthc. 2023;6(1):24–26 https://doi.org/10.36401/JQSH-23-X2
  • [21] Harris S, Nino V, Claudio D. Simulating a sterilization processing department to evaluate block schedules and tray configurations. Syst Eng. 2024;27(1):54–73 https://doi.org/10.1016/j.heliyon.2022.e08944
  • [22] Jildeh ZB, Wagner PH, Schöning MJ. Sterilization of objects, products, and packaging surfaces and their characterization in different fields of ındustry: The Status in 2020. Phys status solidi. 2021;218(13):2000732 https://doi.org/10.1002/pssa.202000732
  • [23] Mascia A, Cirafici AM, Bongiovanni A, Colotti G, Lacerra G, Di Carlo M, et al. A failure mode and effect analysis (FMEA)-based approach for risk assessment of scientific processes in non-regulated research laboratories. Accredit Qual Assur. 2020;25(5):311–321 https://doi.org/10.1007/s00769-020-01441-9
  • [24] Subriadi AP, Najwa NF. The consistency analysis of failure mode and effect analysis (FMEA) in information technology risk assessment. Heliyon. 2020;6(1):e03161 https://doi.org/10.1016/j.heliyon.2020.e03161
  • [25] Mardani Shahri M, Eshraghniaye Jahromi A, Houshmand M. Failure Mode and Effect Analysis using an integrated approach of clustering and MCDM under pythagorean fuzzy environment. J Loss Prev Process Ind. 2021;72:104591 https://doi.org/10.1016/j.jlp.2021.104591
  • [26] Panta G, Richardson AK, Shaw IC, Chambers S, Coope PA. Effectiveness of steam sterilization of reusable medical devices in primary and secondary care public hospitals in Nepal and factors associated with ineffective sterilization: A nation-wide cross-sectional study. PLoS One. 2019;14(11):e0225595 https://doi.org/10.1371/journal.pone.0225595
  • [27] Selvik JT, Signoret JP. How to interpret safety critical failures in risk and reliability assessments. Reliab Eng Syst Saf. 2017;161:61–68 https://doi.org/10.1016/j.ress.2017.01.003
  • [28] Bowles J. An Assessment of RPN Prioritization in a Failure Modes Effects and Criticality Analysis. J IEST. 2003; 47: 380–386 . https://doi.org/10.17764/jiet.47.1.y576m26127157313.
There are 28 citations in total.

Details

Primary Language English
Subjects Pharmacology and Pharmaceutical Sciences (Other)
Journal Section Articles
Authors

Fadela Benzag This is me 0009-0003-9174-2009

Omar Elhamdaoui This is me 0000-0002-6393-9571

Ali Cherif Chefchaouni This is me 0000-0001-8142-1218

Younes Rahali This is me 0000-0003-0287-4636

Yassir El Alaoui This is me 0000-0001-8925-2690

Publication Date September 1, 2025
Submission Date May 30, 2024
Acceptance Date August 24, 2024
Published in Issue Year 2025 Volume: 29 Issue: 5

Cite

APA Benzag, F., Elhamdaoui, O., Chefchaouni, A. C., … Rahali, Y. (2025). Risk management in the sterilization process for reusable medical devices: Moroccan Hospital experience. Journal of Research in Pharmacy, 29(5), 1994-2007. https://doi.org/10.12991/jrespharm.1764962
AMA Benzag F, Elhamdaoui O, Chefchaouni AC, Rahali Y, El Alaoui Y. Risk management in the sterilization process for reusable medical devices: Moroccan Hospital experience. J. Res. Pharm. September 2025;29(5):1994-2007. doi:10.12991/jrespharm.1764962
Chicago Benzag, Fadela, Omar Elhamdaoui, Ali Cherif Chefchaouni, Younes Rahali, and Yassir El Alaoui. “Risk Management in the Sterilization Process for Reusable Medical Devices: Moroccan Hospital Experience”. Journal of Research in Pharmacy 29, no. 5 (September 2025): 1994-2007. https://doi.org/10.12991/jrespharm.1764962.
EndNote Benzag F, Elhamdaoui O, Chefchaouni AC, Rahali Y, El Alaoui Y (September 1, 2025) Risk management in the sterilization process for reusable medical devices: Moroccan Hospital experience. Journal of Research in Pharmacy 29 5 1994–2007.
IEEE F. Benzag, O. Elhamdaoui, A. C. Chefchaouni, Y. Rahali, and Y. El Alaoui, “Risk management in the sterilization process for reusable medical devices: Moroccan Hospital experience”, J. Res. Pharm., vol. 29, no. 5, pp. 1994–2007, 2025, doi: 10.12991/jrespharm.1764962.
ISNAD Benzag, Fadela et al. “Risk Management in the Sterilization Process for Reusable Medical Devices: Moroccan Hospital Experience”. Journal of Research in Pharmacy 29/5 (September2025), 1994-2007. https://doi.org/10.12991/jrespharm.1764962.
JAMA Benzag F, Elhamdaoui O, Chefchaouni AC, Rahali Y, El Alaoui Y. Risk management in the sterilization process for reusable medical devices: Moroccan Hospital experience. J. Res. Pharm. 2025;29:1994–2007.
MLA Benzag, Fadela et al. “Risk Management in the Sterilization Process for Reusable Medical Devices: Moroccan Hospital Experience”. Journal of Research in Pharmacy, vol. 29, no. 5, 2025, pp. 1994-07, doi:10.12991/jrespharm.1764962.
Vancouver Benzag F, Elhamdaoui O, Chefchaouni AC, Rahali Y, El Alaoui Y. Risk management in the sterilization process for reusable medical devices: Moroccan Hospital experience. J. Res. Pharm. 2025;29(5):1994-2007.