Titre
Iatrogenic events in neonates: beneficial effects of prevention strategies and continuous monitoring.
Type
article
Institution
Externe
Périodique
Auteur(s)
Ligi, I.
Auteure/Auteur
Millet, V.
Auteure/Auteur
Sartor, C.
Auteure/Auteur
Jouve, E.
Auteure/Auteur
Tardieu, S.
Auteure/Auteur
Sambuc, R.
Auteure/Auteur
Simeoni, U.
Auteure/Auteur
Liens vers les personnes
ISSN
1098-4275
Statut éditorial
Publié
Date de publication
2010
Volume
126
Numéro
6
Première page
e1461
Dernière page/numéro d’article
e1468
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article Publication Status: ppublish
Résumé
OBJECTIVES: To assess the impact of continuous incident reporting and subsequent prevention strategies on the incidence of severe iatrogenic events and targeted priorities in admitted neonates.
METHODS: We performed preintervention (January 1 to September 1, 2005) and postintervention (January 1, 2008, to January 1, 2009) prospective investigations based on continuous incident reporting. Patient-safety initiatives were implemented for a period of 2 years. The main outcome was a reduction in the incidence of severe iatrogenic events. Secondary outcomes were improvements in 5 targeted priorities: catheter-related infections; invasive procedures; unplanned extubations; 10-fold drug infusion-rate errors; and severe cutaneous injuries.
RESULTS: The first and second study periods included totals of 388 and 645 patients (median gestational ages: 34 and 35 weeks, respectively; P = .015). In the second period the incidence of severe iatrogenic events was significantly reduced from 7.6 to 4.8 per 1000 patient-days (P = .005). Infections related to central catheters decreased significantly from 13.9 to 8.2 per 1000 catheter-days (P < .0001), as did exposure to central catheters, which decreased from 359 to 239 days per 1000 patient-days (P < .0001). Tenfold drug-dosing errors were reduced significantly (P = .022). However, the number of unplanned extubations increased significantly from 5.6 to 15.5 per 1000 ventilation-days (P = .03).
CONCLUSIONS: Prospective, continuous incident reporting followed by the implementation of prevention strategies are complementary procedures that constitute an effective system to improve the quality of care and patient safety.
METHODS: We performed preintervention (January 1 to September 1, 2005) and postintervention (January 1, 2008, to January 1, 2009) prospective investigations based on continuous incident reporting. Patient-safety initiatives were implemented for a period of 2 years. The main outcome was a reduction in the incidence of severe iatrogenic events. Secondary outcomes were improvements in 5 targeted priorities: catheter-related infections; invasive procedures; unplanned extubations; 10-fold drug infusion-rate errors; and severe cutaneous injuries.
RESULTS: The first and second study periods included totals of 388 and 645 patients (median gestational ages: 34 and 35 weeks, respectively; P = .015). In the second period the incidence of severe iatrogenic events was significantly reduced from 7.6 to 4.8 per 1000 patient-days (P = .005). Infections related to central catheters decreased significantly from 13.9 to 8.2 per 1000 catheter-days (P < .0001), as did exposure to central catheters, which decreased from 359 to 239 days per 1000 patient-days (P < .0001). Tenfold drug-dosing errors were reduced significantly (P = .022). However, the number of unplanned extubations increased significantly from 5.6 to 15.5 per 1000 ventilation-days (P = .03).
CONCLUSIONS: Prospective, continuous incident reporting followed by the implementation of prevention strategies are complementary procedures that constitute an effective system to improve the quality of care and patient safety.
PID Serval
serval:BIB_48F839622658
PMID
Date de création
2015-02-22T09:02:50.467Z
Date de création dans IRIS
2025-05-20T16:28:49Z