Real-time safety audits in a neonatal unit

Bergón-Sendín, Elena; Perez-Grande, María del Carmen; Lora-Pablos, David; Melgar-Bonis, Ana; Ureta-Velasco, Noelia; Moral‐Pumarega, María Teresa; Pallás‐Alonso, Carmen Rosa

doi:10.1016/j.anpede.2016.08.010

Cited by 3 publications

(9 citation statements)

References 19 publications

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“…This may be because of the potentially lower caregiver work burden during holidays which could allow greater staff coverage and thus, ensure the proper set-up and preparation of the required materials. 13 14 In this current report, we did not find any significant differences in the overall preparation of CPR stabilization areas according to the day of the week or the shift analyzed. Although there was a tendency toward better preparation of the materials and medications on weekdays compared with weekends; global analysis of the resuscitation area data failed to highlight any statistically significant differences.…”

Section: Discussioncontrasting

confidence: 49%

“…Other authors have also demonstrated the usefulness of RRTSAs in preventing errors resulting from system failures and consider their implementation in NICUs to be fundamental. 7,10,14,15 Limitations It is also important to consider the limitations of our study. First, this was a multicenter study performed in neonatal units with similar delivery-room newborn care provision (level III-A, according to the Spanish Society of Neonatology).…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, our study showed similar global percentages of RRTSAs without defects as those reported by Bergon–Sendin et al who also conducted RRTSAs in different Spanish hospital neonatal areas and NICU work procedures and showed surprisingly low percentages of satisfactory audits. These authors detected defects in areas as important as the use of ventilation materials and respiratory monitoring (383 audits; adequate overall use: 33.7%), 13 resuscitation materials (296 audits; adequate overall use: 62.5%), 14 or infusion pumps (160 audits; adequate global use: 73.1%). 15 This low percentage of audits without defect should lead us to reflect upon whether our current hospital delivery room protocols are able to ensure the correct and complete preparation of positions used during the care of newborns at the time of their delivery.…”

Section: Discussionmentioning

confidence: 99%

“…Other authors have also demonstrated the usefulness of RRTSAs in preventing errors resulting from system failures and consider their implementation in NICUs to be fundamental. 7 10 14 15…”

Section: Discussionmentioning

confidence: 99%

“…7,12 Several studies on RRTSAs have been performed in neonatal intensive care units (NICUs) for various procedures and materials (for example, ventilation and respiratory monitoring, materials available for resuscitation, infusion pumps, and prevention of nosocomial infections). 11,[13][14][15][16] However, to the best of our knowledge, no specific work on RRTSAs has been performed for neonatal delivery room CPR stabilization areas. Thus, the objective of this study was to use audits to verify the level of preparation of these areas, analyze any circumstances that could influence their correct availability, and check the value of this quality-control tool to prevent safety-related incidents in this field.…”

mentioning

confidence: 99%

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Real-Time Safety Audits of Neonatal Delivery Room Resuscitation Areas: Are We Sufficiently Prepared?

Ortiz-Movilla

Funes-Moñux²,

Domingo-Comeche

et al. 2020

Am J Perinatol

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Objective This study aimed to use real-time safety audits to establish whether preparation of the equipment required for the stabilization and resuscitation of newborns in the delivery room areas is adequate. Study Design This was a descriptive, multicenter study performed at five-level III-A neonatal units in Madrid, Spain. For 1 year, one researcher from each center performed random real-time safety audits (RRTSAs), on different days and during different shifts, of at least three neonatal stabilization areas, either in the delivery room or in the operating room used for caesarean sections. Three factors in each area were reviewed: the set-up of the radiant warmer, the materials, and medication available. The global audit was considered without defect when no errors were detected in any of the audited factors. Possible differences in the results were analyzed as a function of the study month, day of the week, or shift during which the audit had been performed. Results A total of 852 audits were performed. No defects were detected in any of the three factors analyzed in the 534 (62.7%, 95% confidence interval [CI]: 59.3–65.9) cases. Slight defects were detected in 98 (11.5%, 95% CI: 9.4–13.8) cases and serious defects capable of producing adverse events in the newborn during resuscitation were found in 220 (25.8%, 95% CI: 22.9–28.9) cases. No statistically significant differences in the results were found according to the day of the week or time during which the audits were performed. However, the percentage of RRTSAs without defect increased as the study period progressed (first quarter 38.1% vs. the last quarter 84.2%; p < 0.001). Conclusion The percentage of adequately prepared resuscitation areas was low. RRTSAs made it possible to detect errors in the correct availability of the neonatal stabilization areas and improved their preparation by preventing errors from being perpetuated over time. Key Points

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Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Other authors have also demonstrated the usefulness of RRTSAs in preventing errors resulting from system failures and consider their implementation in NICUs to be fundamental. 7 10 14 15…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Real-Time Safety Audits of Neonatal Delivery Room Resuscitation Areas: Are We Sufficiently Prepared?

Ortiz-Movilla

Funes-Moñux²,

Domingo-Comeche

et al. 2020

Am J Perinatol

View full text Add to dashboard Cite

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What Is the Opinion of the Health Care Personnel Regarding the Use of Different Assistive Tools to Improve the Quality of Neonatal Resuscitation?

Ortiz-Movilla,

Beato-Merino,

Funes Moñux

et al. 2024

Am J Perinatol

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It is important to determine whether the use of different quality improvement tools in neonatal resuscitation is well-received by healthcare teams and improves coordination and perceived quality of the stabilization of the newborn at birth. OBJECTIVE To explore the satisfaction of personnel involved in resuscitation for infants under 32 weeks of gestational age (<32 wGA) at birth with the use of an assistance toolkit: Random Real-Time Safety Audits (RRSA) of neonatal stabilization stations, the use of pre-CPR checklists, and the implementation of briefings and debriefings. STUDY DESIGN A quasi-experimental, prospective, multicenter intervention study was conducted in five level III-A NICUs in Madrid (Spain). The intervention involved conducting weekly RRSA of neonatal resuscitation stations and the systematic use of checklists, briefings, and debriefings during stabilization at birth for infants <32 wGA. The satisfaction with their use was analyzed through surveys conducted with the personnel responsible for resuscitating these newborns. These surveys were conducted both before and after the intervention phase (each lasting one year) and used a Likert scale response model to assess various aspects of the utility of the introduced assistance tools, team coordination, and perceived quality of the resuscitation. RESULTS Comparison of data from 200 pre-intervention surveys and 155 post-intervention surveys revealed statistically significant differences (p<0.001) between the two phases. The post-intervention phase scored higher in all aspects related to the effective utilization of these tools. Improvements were observed in team coordination and the perceived quality of neonatal resuscitation. These improved scores were consistent across personnel roles and years of experience. CONCLUSION Personnel attending to infants <32 wGA in the delivery room are satisfied with the application of RRSA, checklists, briefings, and debriefings in the neonatal resuscitation and perceive a higher level of quality in the stabilization of these newborns following the introduction of these tools.

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Equipment preparedness for neonatal resuscitation in neonatal intensive care unit in resource limited setting: cross-sectional study

Hassen,

Agegnehu,

Temesgen

et al. 2024

Annals of Medicine &Amp; Surgery

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Background: Adverse health care’s events are a critical issue worldwide, neonatal intensive care unit adverse events are a considerable issue. It is important that we recognize the basic equipment needed to address these circumstances. The aim of this study is to asses’ equipment preparedness for neonatal resuscitation in the neonatal intensive care unit. Method: A hospital- based, cross- sectional study was conducted on 210 neonates admitted to neonatal intensive care unit at comprehensive specialized hospital from 26/03/2022–26/05/2022. The data’s were collected using Check list prepared from Neonatal resuscitation: current evidence and guidelines. The data obtained were summed up and presented as descriptive statistics using the Microsoft Excel and were analyzed using SPSS version 25. The result reported in text and table form. Result: In this study there was 12.72% complete equipment preparation (without defect) in 210 cases. From the total, there was minor defect in 52.8% cases, and 34.45% cases had serious defect. Serious defects were more frequently detected in the equipment preparation (42.46%), resuscitation medications (12.5%), and radiant warmer set-up (40%) Conclusion and recommendation: Overall equipment preparation for neonatal resuscitation was insufficient, and quality of equipment preparation for neonatal resuscitation and stabilization needs to be improved. To enhance equipment preparedness in the NICU staff should establish uniform guidelines

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Real-time safety audits in a neonatal unit

Cited by 3 publications

References 19 publications

Real-Time Safety Audits of Neonatal Delivery Room Resuscitation Areas: Are We Sufficiently Prepared?

Real-Time Safety Audits of Neonatal Delivery Room Resuscitation Areas: Are We Sufficiently Prepared?

What Is the Opinion of the Health Care Personnel Regarding the Use of Different Assistive Tools to Improve the Quality of Neonatal Resuscitation?

Equipment preparedness for neonatal resuscitation in neonatal intensive care unit in resource limited setting: cross-sectional study

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