Intensive Care Medicine

, Volume 41, Issue 6, pp 1089–1098 | Cite as

Feasibility and utility of the use of real time random safety audits in adult ICU patients: a multicentre study

  • M. Bodí
  • M. Olona
  • M. C. Martín
  • R. Alceaga
  • J. C. Rodríguez
  • E. Corral
  • J. M. Pérez Villares
  • G. Sirgo
Original

Abstract

Purpose

The two aims of this study were first to analyse the feasibility and utility (to improve the care process) of implementing a new real time random safety tool and second to explore the efficacy of this tool in core hospitals (those participating in tool design) versus non-core hospitals.

Methods

This was a prospective study conducted over a period of 4 months in six adult intensive care units (two of which were core hospitals). Safety audits were conducted 3 days per week during the entire study period to determine the efficacy of the 37 safety measures (grouped into ten blocks). In each audit, 50 % of patients and 50 % of measures were randomized. Feasibility was calculated as the proportion of audits completed over those scheduled and time spent, and utility was defined as the changes in the care process resulting from tool application.

Results

A total of 1323 patient-days were analysed. In terms of feasibility, 87.6 % of the scheduled audits were completed. The average time spent per audit was 34.5 ± 29 min. Globally, changes in the care process occurred in 5.4 % of the measures analysed. In core hospitals, utility was significantly higher in 16 of the 37 measures, all of which were included in good clinical practice guidelines. Most of the clinical changes brought about by the tool occurred in the mechanical ventilation and haemodynamics blocks. Multivariate analyses demonstrated that changes in the care process in each block were associated with the core hospital variable, staffing ratios and severity of patient disease.

Conclusions

Real time safety audits improved the care process and adherence to the clinical practice guidelines and proved to be most useful in situations of high care load and in patients with more severe disease. The effect was greater in core hospitals.

Keywords

Safety Intensive care unit Critical patients Real time safety audits 

Notes

Acknowledgments

This study was supported by grants from the Fondo de Investigación Sanitaria (Institute of Health Carlos III from Spain, FIS grants, project PI11/02311). The project is endorsed by the Work Group on Planning, Organization and Management of the Spanish Society of Intensive Medicine and was awarded second prize for the best communication at the National Congress of the Spanish Society of Intensive Medicine, 2014.

Supplementary material

134_2015_3792_MOESM1_ESM.pdf (163 kb)
Supplementary material 1 (PDF 162 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2015

Authors and Affiliations

  • M. Bodí
    • 1
    • 8
  • M. Olona
    • 2
  • M. C. Martín
    • 3
  • R. Alceaga
    • 4
  • J. C. Rodríguez
    • 5
  • E. Corral
    • 6
  • J. M. Pérez Villares
    • 7
  • G. Sirgo
    • 1
  1. 1.Intensive Care Unit, Hospital Universitario Joan XXIII, Instituto de Investigación Sanitaria Pere VirgiliRovira I Virgili UniversityTarragonaSpain
  2. 2.Department of Preventive Medicine, Hospital Universitario Joan XXIII, Instituto de Investigación Sanitaria Pere VirgiliRovira I Virgili UniversityTarragonaSpain
  3. 3.Intensive Care UnitHospital Universitario de TorrejónMadridSpain
  4. 4.Intensive Care UnitHospital Santa TeclaTarragonaSpain
  5. 5.Intensive Care UnitHospital Universitario Marques de ValdecillaSantanderSpain
  6. 6.Intensive Care UnitHospital Universitario Santiago ApostolVitoriaSpain
  7. 7.Neurocritical UnitHospital Universitario Virgen de las NievesGranadaSpain
  8. 8.TarragonaSpain

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