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

Authors :
Ligi I
Millet V
Sartor C
Jouve E
Tardieu S
Sambuc R
Simeoni U
Source :
Pediatrics [Pediatrics] 2010 Dec; Vol. 126 (6), pp. e1461-8. Date of Electronic Publication: 2010 Nov 15.
Publication Year :
2010

Abstract

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.<br />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.<br />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).<br />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.

Details

Language :
English
ISSN :
1098-4275
Volume :
126
Issue :
6
Database :
MEDLINE
Journal :
Pediatrics
Publication Type :
Academic Journal
Accession number :
21078738
Full Text :
https://doi.org/10.1542/peds.2009-2872