G Sirgo Rodríguez1, M Olona Cabases2, M C Martin Delgado3, F Esteban Reboll4, A Pobo Peris4, M Bodí Saera4. 1. Intensive Care Unit, Hospital Universitari Joan XXIII, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Tarragona, Spain. Electronic address: gsirgoluanco@yahoo.es. 2. Preventive Medicine Department, Hospital Universitari Joan XXIII, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Tarragona, Spain. 3. Intensive Care Unit, Torrejón University Hospital, Torrejón de Ardoz, Madrid, Spain. 4. Intensive Care Unit, Hospital Universitari Joan XXIII, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Tarragona, Spain.
Abstract
UNLABELLED: Adverse events significantly impact upon mortality rates and healthcare costs. PURPOSE: To design a checklist of safety measures based on relevant scientific literature, apply random checklist measures to critically ill patients in real time (safety audits), and determine its utility and feasibility. METHODS: A list of safety measures based on scientific literature was drawn up by investigators. Subsequently, a group of selected experts evaluated these measures using the Delphi methodology. Audits were carried out on 14 days over a period of one month. Each day, 50% of the measures were randomly selected and measured in 50% of the randomized patients. Utility was assessed by measuring the changes in clinical performance after audits, using the variable improvement proportion related to audits. Feasibility was determined by the successful completion of auditing on each of the days on which audits were attempted. RESULTS: The final verified checklist comprised 37 measures distributed into 10 blocks. The improvement proportion related to audits was reported in 83.78% of the measures. This proportion was over 25% in the following measures: assessment of the alveolar pressure limit, checking of mechanical ventilation alarms, checking of monitor alarms, correct prescription of the daily treatment orders, daily evaluation of the need for catheters, enteral nutrition monitoring, assessment of semi-recumbent position, and checking that patient clinical information is properly organized in the clinical history. Feasibility: rounds were completed on the 14 proposed days. CONCLUSIONS: Audits in real time are a useful and feasible tool for modifying clinical actions and minimizing errors.
RCT Entities:
UNLABELLED: Adverse events significantly impact upon mortality rates and healthcare costs. PURPOSE: To design a checklist of safety measures based on relevant scientific literature, apply random checklist measures to critically illpatients in real time (safety audits), and determine its utility and feasibility. METHODS: A list of safety measures based on scientific literature was drawn up by investigators. Subsequently, a group of selected experts evaluated these measures using the Delphi methodology. Audits were carried out on 14 days over a period of one month. Each day, 50% of the measures were randomly selected and measured in 50% of the randomized patients. Utility was assessed by measuring the changes in clinical performance after audits, using the variable improvement proportion related to audits. Feasibility was determined by the successful completion of auditing on each of the days on which audits were attempted. RESULTS: The final verified checklist comprised 37 measures distributed into 10 blocks. The improvement proportion related to audits was reported in 83.78% of the measures. This proportion was over 25% in the following measures: assessment of the alveolar pressure limit, checking of mechanical ventilation alarms, checking of monitor alarms, correct prescription of the daily treatment orders, daily evaluation of the need for catheters, enteral nutrition monitoring, assessment of semi-recumbent position, and checking that patient clinical information is properly organized in the clinical history. Feasibility: rounds were completed on the 14 proposed days. CONCLUSIONS: Audits in real time are a useful and feasible tool for modifying clinical actions and minimizing errors.
Authors: M Bodí; M Olona; M C Martín; R Alceaga; J C Rodríguez; E Corral; J M Pérez Villares; G Sirgo Journal: Intensive Care Med Date: 2015-04-14 Impact factor: 17.440
Authors: María Bodí; Iban Oliva; Maria Cruz Martín; Maria Carmen Gilavert; Carlos Muñoz; Montserrat Olona; Gonzalo Sirgo Journal: Ann Intensive Care Date: 2017-02-28 Impact factor: 6.925
Authors: Elena Bergon-Sendin; Carmen Perez-Grande; David Lora-Pablos; Javier De la Cruz Bertolo; María Teresa Moral-Pumarega; Gerardo Bustos-Lozano; Carmen Rosa Pallas-Alonso Journal: Biomed Res Int Date: 2015-10-19 Impact factor: 3.411