RESUMEN
Patient safety has become a central component of quality of care. One of the best known and most widely used security tool in all work settings is the checklist. The checklist is a tool that helps to not forget any step during the performance of a procedure, to do tasks with an established order, to control the fulfilment of a series of requirements or to collect data in a systematic way for its subsequent analysis. It is an aid to improve the efficiency of teamwork, promote communication, decrease variability, standardize care and improve patient safety. Main barriers to implementation are reviewed: staff attitudes, hierarchies, poor design, inadequate training, duplication with other work lists, work overload, cultural barriers, lack of replication or checklist closing time. Finally, its applications in Pediatrics are reviewed starting from the most widespread, the safety checklist of pediatric surgery, checklists in neonatal critical units, for safe delivery, for risk procedures, in pediatric intensive care and for pathology time-dependent emergent, e.g. pediatric trauma. It is necessary to highlight the role of leadership in the implantation of a checklist in any area of Pediatrics. There must be one or more people from the team with the support of the Heads of Service and Managers who lead the training of the personnel, direct the implementation of the LV, evaluate the results, inform the rest of the team and can modify the processes depending on the problems found.
Asunto(s)
Lista de Verificación , Atención a la Salud/normas , Seguridad del Paciente/normas , Calidad de la Atención de Salud , Niño , Comunicación , Humanos , Recién Nacido , Liderazgo , Pediatría/normasRESUMEN
The difficulty to keep our patients' skin intact combined with few articles on this topic in pediatrics led the authors to carry out a study in their Pediatrics Intensive Care Unit "UCIP" at the Central University Hospital of Asturias, HUCA. The objective of this study consisted in determining if a decrease in the appearance of bed sores in children checked into their unit after a program whose purpose was to prevent bed sores had been applied occurred. This retrospective/prospective, comparative, observational study dealt with patients checked in their UCIP from September 2004 to September 2007; patients were broken into two groups, before and after applying a protocol and comparing the following variables: the number of patients checked in during each of the periods of this study; patients who had bed sores; average time kept in this ward for each group; pathologies patients who suffered from bed sores had when checked into this ward; the site and degree of these bed sores. Although there was an increase in the number of patients checked into this unit, the number of bed sores among children in this unit decreased 24.6% during the second period after the application of the protocol. Among the study observations noted there was a reduction in the severity of lesions patients manifested, as well as important differences as to where their lesions were located. Based on the results of the authors' study, one may conclude that the measures included in the bed sore prevention protocol, as well as the use of Mepentol hyperoxygenated fatty acids, have proven effective in their UCIP leading to a decrease in the number of patients which evidenced bed sores and the severity of these lesions was much less.
