重症监护病房安全轮模型的设计

IF 1.1 Q3 NURSING Enfermeria Intensiva Pub Date : 2023-10-01 DOI:10.1016/j.enfi.2023.01.002
M.E. Rodríguez-Delgado RN , A.M. Echeverría-Álvarez RN , M. Colmenero-Ruiz MDPhD , R. Morón-Romero PharmD. PhD , A. Cobos-Vargas RN , A. Bueno-Cavanillas MDPhD , en nombre del Grupo de trabajo de rondas de seguridad en UCI
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引用次数: 0

摘要

简介安全回合(SR)是一种操作工具,可以了解良好做法的遵守情况,帮助识别患者安全(PS)中的风险和事件,并实施改进措施。本研究的目的是设计一种在重症监护室(ICU)进行SR的程序。方法在不同学科和类别的管理人员、中层管理人员和专业人员的参与下,通过名义小组技术编制ICU SR发展检查表。首先,一个专家组根据关于PS良好做法的建议,商定了项目的定义、编码、遵守标准以及不遵守的影响。随后,通过对两个SR进行试点的横断面研究来确定其可行性,以在实际临床实践条件下调整项目。结果通过检查表获得了一个具体的ICU SR模型。专家组编制了第一份清单,由6个基本方面的39个项目组成,并确定了执行方法。完成两次SR的平均时间为85分钟,包括简报和随后的汇报。验证试点后,维度减少到5个,删除了3个项目,将2个项目转移到另一个维度,修改了3个与医院感染和知情同意书有关的项目。此外,还重新定义了数据来源、遵守标准及其相对权重。最后的清单被认为是有益的,对改进实践具有相关性。结论通过协商一致的方法,建立了用于ICU RS的检查表。该模型可以作为其在具有类似特征的医疗保健服务中使用的基础。
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Diseño de un modelo de ronda de seguridad para unidades de cuidados intensivos

Introduction

Safety Rounds (SR) are an operational tool that allow knowing adherence to good practices, help identify risks and incidents in patient safety (PS), allowing improvement actions to be implemented. The objective of this work was the design of a procedure to perform SR in an Intensive Care Unit (ICU).

Methods

Preparation of a checklist for the development of SR in the ICU through the nominal group technique, with the participation of managers, middle managers and professionals from different disciplines and categories. In the first place, a group of experts agreed, based on the recommendations on good practices in PS, the definition of items, their coding, the criteria for compliance and the impact of non-compliance. Subsequently, its viability was determined through a cross-sectional study through the piloting of two SRs to adjust the items in real clinical practice conditions.

Results

A specific SR model for ICUs has been obtained through a checklist. The group of experts prepared a first list made up of 39 items of 6 essential dimensions and defined the method of implementation. Mean time to complete the two SRs was 85 minutes, including the briefing and subsequent debriefing. After the validation pilot, the dimensions were reduced to 5, 3 items were deleted, 2 items were transferred to another dimension and 3 items related to nosocomial infections and informed consent were modified. In addition, the data sources, the compliance criteria and their relative weight were redefined. The final list was considered useful and relevant to improve practice.

Conclusions

Through a consensus methodology, a checklist has been built to be used in the RS of an ICU. This model can serve as a basis for its use in healthcare services with similar characteristics.

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来源期刊
CiteScore
2.50
自引率
23.10%
发文量
48
期刊介绍: Enfermería Intensiva es el medio de comunicación por antonomasia para todos los profesionales de enfermería españoles que desarrollan su actividad profesional en las unidades de cuidados intensivos o en cualquier otro lugar donde se atiende al paciente crítico. Enfermería Intensiva publica cuatro números al año, cuyos temas son específicos para la enfermería de cuidados intensivos. Es la única publicación en español con carácter nacional y está indexada en prestigiosas bases de datos como International Nursing Index, MEDLINE, Índice de Enfermería, Cuiden, Índice Médico Español, Toxline, etc.
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