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Description
Determination of which contributing factor(s) related to devices, equipment, or supplies are known.
On-Screen Instructions
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Field Type
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The availability, or lack thereof, of a device, equipment, or supply contributed to the event.
Includes
Device, equipment or supply not adequately stocked
Device, equipment or supply not available when needed
Device, equipment or supply not accessible when needed
Device, equipment or supply correct size not available
Device, equipment or supply available when it should not have been
Excludes
Shortages (select “Shortage”)
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The design of a device, equipment, or supply, regardless of how it functions, contributed to the event.
Includes
Device or equipment display or controls not well-designed, difficult to read, or difficult to program
Device, equipment or supply awkward to use correctly
Device, equipment, or supply did not have built in safety features
Excludes
Device, equipment, or supply was not designed for the task for which it was being used (select “Use or selection by pharmacist or staff”)
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The function of a device, equipment, or supply, regardless of how it is designed, contributed to the event. Function includes devices or supplies that are defective, non-working, or do not meet code.
Includes
Defective or non-working device, equipment, or supply (including defective or dysfunctional alerts)
Device display or controls not functioning
Broken or defective device, equipment, or supply that was awaiting repair contributed to the event
Excludes
Device, equipment, or supply that functioned as intended, but whose design contributed to the event (select “Design”)
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Routine maintenance, or lack thereof, of a device, equipment, or supply contributed to the event.
Includes
Device, equipment, or supply did not meet code, specifications, or regulations
Inadequate maintenance log
Inadequate or delayed maintenance
Inadequate cleaning or sterilization
Excludes
Broken or defective device, equipment, or supply that was awaiting repair contributed to the event (select “Function”)
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Manufacturer shortage of a device, equipment, or supply contributed to the event.
Includes
Device, equipment, or supply not readily available due to a manufacturer shortage
Medication supply shortages
Excludes
Failure to properly stock supplies (select “Availability”)
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The use of a device, equipment, or supply for other than its intended purpose or the incorrect use of a device contributed to the event.
Includes
Pharmacist or staff member did not use the device, equipment, or supply correctly
Pharmacist or staff member did not select the correct device, equipment, or supply for the task at hand
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Any other factor related to the device, equipment, or supply, not included in the list above, contributed to the event.
Includes
Recalls
Excludes
Problems with health information technology (HIT) (select from the Computer Systems contributing factors category)
Guide for Use
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History
Start Date | 2013 |
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End Date | n/a |
Change History | January 2016: Changed “Function” and “Function (including device failure)” to “Function (e.g., defective, non-working)”; added “Shortage”, “Use or selection by healthcare provider or staff”; “Use error changed to “Use or selection by pharmacist or staff” |