Abstract
BackgroundRandom safety audits (RSA) are a safety tool enabling prevention of adverse events, but they have not been widely used in hospitals. The aim of this study was to use RSAs to assess and compare the frequency of appropriate use of infusion pump safety systems in a Neonatal Intensive Care Unit (NICU) before and after quality improvement interventions and to analyse the intravenous medication programming data.MethodsProspective, observational study comparing the frequency of appropriate use of Alaris® CC smart pumps through RSAs over two periods, from 1 January to 31 December 2012 and from 1 November 2014 to 31 January 2015. Appropriate use was defined as all evaluated variables being correctly programmed into the same device. Between the two periods they were established interventions to improve the use of pumps. The information recorded at the pumps with the new security system, also extracted for one year.ResultsFifty-two measurements were collected during the first period and 160 measurements during the second period. The frequency of appropriate use was 73.13 % (117/160) in the second period versus 0 % (0/52) in the first period (p < 0.0001). Information was recorded on 44,924 infusions; in 46.03 % (20,680/44,924) of cases the drug name was recorded. In 2.5 % (532/20,680) of cases there was an attempt to exceed the absolute limit.ConclusionsRandom Safety Audits were a very useful tool for detecting inappropriate use of pumps in the NICU. The improvement strategies were effective for improving appropriate use and programming of the intravenous medication infusion pumps in our NICU.
Highlights
Random safety audits (RSA) are a safety tool enabling prevention of adverse events, but they have not been widely used in hospitals
Critical situations occur in Neonatal Intensive Care Units (NICUs), which can lead to related events through the inappropriate use of technological devices
Prospective, observational study comparing two periods through rounds of audits in which data related to the use of Alaris® CC syringe infusion pump safety systems was collected in a level III-C NICU with around 500 admissions per year in intensive care
Summary
Random safety audits (RSA) are a safety tool enabling prevention of adverse events, but they have not been widely used in hospitals. The aim of this study was to use RSAs to assess and compare the frequency of appropriate use of infusion pump safety systems in a Neonatal Intensive Care Unit (NICU) before and after quality improvement interventions and to analyse the intravenous medication programming data. Advances in neonatology care have achieved an increase in the survival rate of premature and ill newborns. These patients frequently require intravenous treatment which poses a higher risk of adverse events [1]. Neonatal Intensive Care Units (NICUs) are highly complex units, because of the type of patients they care for, and because of the wide range of technology they use. The prevalence of devicerelated errors and their consequences for patients are still not well-defined [5, 6]
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