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. ):473-482 474 G. Sirgo Rodríguez et al. Conclusions: Audits in real time are a useful and feasible tool for modifying clinical actions and minimizing errors.Seguridad; Cuidados intensivos; Auditorías en tiempo real
Análisis aleatorios de seguridad en medicina intensiva: definición y estudio pilotoResumen Los eventos adversos impactan significativamente en la mortalidad y costes sanitarios. Objetivos: Elaborar un listado de verificación de medidas de seguridad basadas en la literatura científica más relevante, aplicarlo en tiempo real y aleatoriamente (rondas de seguridad) y determinar su utilidad y factibilidad. Diseño: Los investigadores desarrollaron un listado de medidas de seguridad basado en la literatura científica. Posteriormente, mediante el método Delphi un grupo de expertos consensuaron las medidas. Las auditorías fueron realizadas en 14 días durante un mes. Cada día se seleccionaron aleatoriamente el 50% de las variables y se midieron en el 50% de los pacientes. La utilidad se determinó midiendo las modificaciones en la actuación clínica usando la variable «proporción de mejora relacionada con las auditorías». La factibilidad fue determinada por la capacidad de realizar los análisis cada día que fueron previstos. Resultados: El listado de verificación estuvo formado por 37 medidas distribuidas en 10 bloques. En el 83,78% de las medidas se produjeron modificaciones después de las rondas. La proporción de mejora relacionada con las rondas fue super...
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