PP156 Risk Assessment Of Equipment Used In Intensive Care Units

2018 ◽  
Vol 34 (S1) ◽  
pp. 127-128
Author(s):  
Juang Horng Jyh ◽  
Loraine Martins Diamente ◽  
César Tadeu Spadella
Keyword(s):  
Adverse Event ◽  
Intensive Care ◽  
Quality Of Care ◽  
Adverse Events ◽  
Intensive Care Units ◽  
Healthcare Professionals ◽  
Critical Patients ◽  
Process Failures ◽  
Hospital Equipment

Introduction:Knowledge and proper use of hospital equipment are essential for preventing adverse events associated with their use. The risks controls for medical devices and equipment are of major importance in ensuring patient safety and the quality of care delivered by healthcare professionals. Monitoring equipment (ME), infusion pumps (IP), and mechanical ventilators (MV) are frequently used in intensive care units, but they are subject to technical, human, and process failures that may pose harm to and even cause the death of patients. The aim of this study was to evaluate the risks related to the use of ME, IP, and MV in the adult intensive care unit (AICU) of a public hospital in Brazil, and to investigate the causes of technical complaints and the adverse events associated with them. We hope the outcomes may serve as a basis for the facility to create mechanisms to diminish the risk and increase the safety and quality of care delivered to critical patientsMethods:A 12-month prospective, observational descriptive study was conducted using an active and passive search of processes related to: hospital medical equipment use; available human and material resources; training programs and continuing professional education; equipment disinfection, sterilization, and assembly processes; and the hospital risk management measures regarding the reports and actions for technical, human, and process failures and the adverse events and incidents related to them. All the data collected were checked against current Brazilian legislation and the equipment technical manuals. The root cause of every failure and adverse event was investigated.Results:The active search identified seventy-five reports on technical complaints in the study period: sixty-five were related to IP, six to ME, and four to MV. The reasons for the complaints included: deficiencies in the quantity, qualification, training, and capacity of professionals handling the devices; inadequate disinfection of MV accessories; absence of or difficulty in accessing the equipment technical manuals; and a lack of preventive and corrective maintenance programs. One single adverse event caused by an IP medication error was attributed to a programing error.Conclusions:Failures and deficiencies in the knowledge and management of hospital equipment can potentially increase risks to patients and healthcare professionals. Increasing compliance with Brazil's current legislation related to the technical and operational norms of hospital equipment might create safer practices and improve care quality for critical patients.

Impact of Morbidity and Mortality Conferences on Analysis of Mortality and Critical Events in Intensive Care Practice

2010 ◽  
Vol 19 (2) ◽  
pp. 135-145 ◽  
Author(s):  
Hatem Ksouri ◽  
Per-Yann Balanant ◽  
Jean-Marc Tadié ◽  
Guillaume Heraud ◽  
Imad Abboud ◽  
...  
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Quality Of Care ◽  
Adverse Events ◽  
Intensive Care Units ◽  
Morbidity And Mortality ◽  
Care Practice ◽  
Unplanned Extubation ◽  
Morbidity And Mortality Conferences

Background Morbidity and mortality conferences are a tool for evaluating care management, but they lack a precise format for practice in intensive care units. Objectives To evaluate the feasibility and usefulness of regular morbidity and mortality conferences specific to intensive care units for improving quality of care and patient safety. Methods For 1 year, a prospective study was conducted in an 18-bed intensive care unit. Events analyzed included deaths in the unit and 4 adverse events (unexpected cardiac arrest, unplanned extubation, reintubation within 24–48 hours after planned extubation, and readmission to the unit within 48 hours after discharge) considered potentially preventable in optimal intensive care practice. During conferences, events were collectively analyzed with the help of an external auditor to determine their severity, causality, and preventability. Results During the study period, 260 deaths and 100 adverse events involving 300 patients were analyzed. The adverse events rate was 16.6 per 1000 patient-days. Adverse events occurred more often between noon and 4 pm (P = .001).The conference consensus was that 6.1% of deaths and 36% of adverse events were preventable. Preventable deaths were associated with iatrogenesis (P = .008), human errors (P < .001), and failure of unit management factors or communication (P = .003). Three major recommendations were made concerning standardization of care or prescription and organizational management, and no similar incidents have recurred. Conclusion In addition to their educational value, regular morbidity and mortality conferences formatted for intensive care units are useful for assessing quality of care and patient safety.

Experience of clinical testing of personal telemedicine system ‘Obereg’ for remote monitoring of patients in intensive care units

2020 ◽  
pp. 52-58 ◽  
Author(s):  
A. A. Eryomenko ◽  
N. V. Rostunova ◽  
S. A. Budagyan ◽  
V. V. Stets
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Remote Monitoring ◽  
Clinical Testing ◽  
Transportation Of Patients ◽  
High Quality ◽  
Telemedicine System ◽  
Accuracy Of Measurements ◽  
Hospital Equipment

The experience of clinical testing of the personal telemedicine system ‘Obereg’ for remote monitoring of patients at the intensive care units of leading Russian clinics is described. The high quality of communication with the remote receiving devices of doctors, the accuracy of measurements, resistance to interference from various hospital equipment and the absence of its own impact on such equipment were confirmed. There are significant advantages compared to stationary patient monitors, in particular, for intra and out-of-hospital transportation of patients.

scholarly journals Effect of Evidence-Based Nursing Care Guidelines on the Quality of Care of Patients in Neurosurgical Intensive Care Units

2020 ◽  
Vol 24 (1) ◽  
pp. 56-67
Author(s):  
Zahra Tayebi Myaneh ◽  
◽  
Maryam Azadi ◽  
Seyedeh Zahra Hosseinigolafshani ◽  
Farnoosh Rashvand ◽  
...  
Keyword(s):  
Intensive Care ◽  
Quality Of Care ◽  
Intensive Care Units ◽  
Nursing Care ◽  
Evidence Based ◽  
Neurosurgical Intensive Care ◽  
Care Guidelines ◽  
The Mean ◽  
Evidence Based Nursing

Background: Evidence-based nursing care guidelines are important tools for increasing the quality of nurses’ clinical work. Objective: The aim of this study was to investigate the effect of implementing evidence-based nursing care guidelines on the quality of care of patients admitted to the Neurosurgical Intensive Care Units (NICUs). Methods: This is a quasi-experimental study on 54 nurses in NICUs of hospitals affiliated to Qazvin University of Medical Sciences selected using a convenience sampling technique and divided into two groups of intervention and control. The intervention included the teaching of evidence-based nursing guidelines and their implementation by the nurses. Before and two months after the intervention, the demographic characteristics and the quality of nurses’ patient care in both groups was evaluated by using a demographic form and a standard checklist with 37 items designed based on the standards of practice for All Registered Nurses (ANA). Data were analyzed in SPSS software using descriptive statistics (Mean±SD), and paired t-test, independent t-test and chi-square test. Findings: The mean score of nursing care quality in the two groups was not significantly different before intervention (P>0.05). After intervention, the mean score was 25.11±6.2 in the intervention group and 20.29±5.3 in the control group, and the difference was statistically significant (P<0.05). Conclusion: Implementation of evidence-based nursing care guidelines can improve the quality of nursing care. Therefore, it is recommended that the teaching of evidence-based nursing care guidelines should be on the agenda of the hospitals’ education unit and related departments.

Understanding articles comparing outcomes among intensive care units to rate quality of care

1998 ◽  
Vol 26 (4) ◽  
pp. 773-781 ◽  
Author(s):  
Adrienne G. Randolph ◽  
Gordon H. Guyatt ◽  
Jean Carlet
Keyword(s):  
Intensive Care ◽  
Quality Of Care ◽  
Intensive Care Units

scholarly journals How to improve the quality of care for people on home mechanical ventilation from the perspective of healthcare professionals: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hanna Klingshirn ◽  
Laura Gerken ◽  
Katharina Hofmann ◽  
Peter Ulrich Heuschmann ◽  
Kirsten Haas ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Quality Of Care ◽  
Service Delivery ◽  
Integrated Care ◽  
Healthcare Professionals ◽  
Home Mechanical Ventilation ◽  
Care Structure ◽  
Quality Framework

Abstract Background The rapid increase in the use of home mechanical ventilation (HMV) for people with chronic respiratory failure poses extreme challenges for the healthcare system. People on HMV have complex care needs and require support from an interprofessional team. In Germany, HMV is criticised for inadequate quality standards, particularly in outpatient intensive care practice. The objective of this study was to describe the quality of care for people on outpatient HMV in Germany, Bavaria and provide recommendations for improvement from the perspective of healthcare professionals (HCPs). Methods Semi-structured qualitative telephone interviews with HCPs (i.e., nurses, equipment providers, therapists, and physicians) were analysed using the framework method. The quality framework of Health Improvement Scotland (HIS), which aims to improve the quality of person-centred care, was used to build a deductive analysis matrix. The framework includes the three key areas: (1) Outcomes and impact, (2) Service delivery, and (3) Vision and leadership. The domains (meta-codes) and quality indicators (sub-codes) of the quality framework were used for deductive coding. Results Overall, 87 HCPs (51 female, mean age of 44.3 years, mean professional experience in HMV of 9.4 years) were interviewed (mean duration of 31 min). There was a complex interaction between the existing health care system (Outcomes and impact, 955 meaning units), the delivery of outpatient intensive care (Service delivery, 939 meaning units), and improvement-focused leadership (Vision and leadership, 70 meaning units) that influenced the quality of care for people on HMV. The main barriers were an acceleration in transition management, a neglect of weaning potential, a shortage of qualified professionals and missing quality criteria. The central recommendations for promoting person-centred care were training and supervision of staff and an inspiring leadership. An integrated care structure supporting medical home visits and outpatient rehabilitation should be developed. Conclusion This study describes a heterogeneous and partly deficient care situation for people on HMV, but demonstrates that high quality care is possible if person-centred care is successfully implemented in all areas of service provision. The recommendations of this study could inform the development of a person-centred integrated care structure for people on HMV.

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