Abstract
Aims & Objectives: There is a dearth of literature about the Quality indicators of Pediatric Intensive Care units (PICU). Methods This is a retrospective analysis of two-year (January 2016 till December 2017) quality indicators which were collected on an everyday basis by a team of Quality manager, clinical pharmacist and infection control nurse. Our 14 bedded PICU is part of a hospital which is accredited by National Accreditation Board for Hospitals and healthcare providers (NABH), complying with the International Society for Quality in Healthcare (ISQua) standards. Results During the study period, there were 2143 admissions, 712 ventilated (47 on High Frequency Oscillator). 30 children underwent CRRT. Standardized-mortality rate (based on PRISM-3) was 80.08. SOFA score below 6 predicted survival with 87.7% sensitivity and 87.1% and specificity. PRISM-3 score below 8 predicted survival with 88.7% sensitivity and 69.9% specificity. Average ventilator-days was 3.47 days. Re-intubation rate was 13.2%, readmissions in PICU in 48 hours 1.17%. Incidence of pressure-sores was 12.2/1000 patient days, needle-stick injuries was 0.06/10000 venepunctures and fall-from-bed was 0.45/1000 days. Incidence of medication-errors was 4.8/1000 patient days. Incidence of Ventilator-Associated Pneumonia (VAP) was 11.5/1000 ventilator days, Catheter-Related Bloodstream Infection (CRBSI) was 4.32/1000 catheter days, Catheter-Associated Urinary Tract Infection was zero. Compliance to hand hygiene was 72.8%. Patients developing VAP had longer ventilator-days (p=0.006) and higher mortality (p=0.04). Patients getting re-intubated had higher but not statistically significant (p=0.59) VAP rate. 78.7% patients strongly agreed to recommend the PICU to others. Conclusions Our data represents a single unit in India. Collaboration from multiple units is essential to develop national and international databank and benchmarking.
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