Iatrogenic events in neonates: beneficial effects of prevention strategies and continuous monitoring.

Détails

ID Serval
serval:BIB_48F839622658
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Iatrogenic events in neonates: beneficial effects of prevention strategies and continuous monitoring.
Périodique
Pediatrics
Auteur(s)
Ligi I., Millet V., Sartor C., Jouve E., Tardieu S., Sambuc R., Simeoni U.
ISSN
1098-4275 (Electronic)
ISSN-L
0031-4005
Statut éditorial
Publié
Date de publication
2010
Peer-reviewed
Oui
Volume
126
Numéro
6
Pages
e1461-e1468
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.
Mots-clé
Female, hic" UI="D005602">France/epidemiology, Gestational Age, Humans, Iatrogenic Disease/epidemiology, Iatrogenic Disease/prevention & control, Incidence, Infant, Newborn, Male, Medication Errors/prevention & control, Monitoring, Physiologic/methods, Practice Guidelines as Topic, Prognosis, Prospective Studies, Quality Assurance, Health Care, Risk Management/methods
Pubmed
Web of science
Création de la notice
22/02/2015 11:02
Dernière modification de la notice
03/03/2018 16:53
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