Objective: To reduce the errors and overflow risks in the preparation of cytotoxic drugs in pharmacy intravenous admixture services (PIVAS). Methods: Failure mode

effects and criticality analysis (FMECA) was used in the preparation of cytotoxic drugs including drug requisition

medical order review

labeling and drug placement

dosing

finished infusion checking and sorting out

failure modes and hazard ratings were evaluated. Effect of the rectification was evaluated by comparing the risk priority value (RPN) and error events before and after the implementation of FMECA. Results: Totally 15 failure modes with high and medium hazard rating were identified and active measures were implemented. After the implementation of FMECA

RPN was reduced by 54. 4%

as well as error events were significantly reduced. Conclusion: The use of FMECA for risk prevention management in the preparation of cytotoxic drugs can effectively reduce error events and ensure the safety of patients and medical staff.