Evaluation of the degree of implementation of zero projects in critical care units of Galicia (Spain) through internal audits.

ABSTRACT

OBJECTIVE: The objective of this study was to assess the implementation of Zero Projects in Critical Care Units (CCUs) through Internal Audits (IA). MATERIALS AND METHODS: Design: Real-time observational safety analysis. A questionnaire was developed with defined items to ensure objectivity. After IAs, a survey was conducted with the auditors. SCOPE 11 CCUs in hospitals of the Servizo Galego de Saúde and Ribera-POVISA. PATIENTS OR PARTICIPANTS: 24 auditors in 9 teams composed of medical, nursing, and quality personnel from health areas and 34 patients were assessed. MAIN VARIABLES OF INTEREST Compliance with the quality standard (≥60% of items), strengths, areas for improvement, auditor's interest in IA, conformity with the organization and items. RESULTS: 100% CCUs met the quality standard. 18.03% of items were fulfilled by all CCUs. Strengths staff motivation, positive reception of auditors, and use of computer tools in some CCUs. Areas for improvement deficit of automatic systems for controlling endotracheal tube cuff pressure (compliance rate in 9.1% of CCUs), training needs, communication issues, and not using checklists (45.5% of the reports). Auditors found IA very interesting, and 19% suggested improving organization and items. CONCLUSIONS: All CCUs met the previously agreed-upon quality standard. Numerous improvement opportunities were identified and communicated to the audited CCUs. For greater homogeneity and objectivity, a review of previously agreed items and definitions is required.