Impact of strategic planning, organizational culture imprint and care bundles to reduce adverse events in the ICU.
Int J Qual Health Care
; 31(6): 480-484, 2019 Jul 01.
Article
em En
| MEDLINE
| ID: mdl-30256944
ABSTRACT
OBJECTIVE:
To evaluate the occurrence of adverse events during a multifaceted program implementation.DESIGN:
Cross-sectional secondary analysis.SETTING:
The respiratory-ICU of a large tertiary care center.PARTICIPANTS:
Retrospectively collected data of patients admitted from 1 March 2010 to 28 February 2014 (usual care period) and from 1 March 2014 to 1 March 2017 (multifaceted program period) were used.INTERVENTIONS:
The program integrated three components (1) strategic planning and organizational culture imprint; (2) training and practice and (3) implementation of care bundles. Strategic planning redefined the respiratory-ICU Mission and Vision, its SWOT matrix (strengths, weaknesses, opportunities, threats) as well as its medium to long-term aims and planned actions. A 'Wear the Institution's T-shirt' monthly conference was given in order to foster organizational culture in healthcare personnel. Training was conducted on hand hygiene and projects 'Pneumonia Zero' and 'Bacteremia Zero'. Finally, actions of both projects were implemented. MAIN OUTCOMEMEASURES:
Rates of adverse events (episodes per 1000 patient/days).RESULTS:
Out of 1662 patients (usual care, n = 981; multifaceted program, n = 681) there was a statistically significant reduction during the multifaceted program in episodes of accidental extubation ([Rate ratio, 95% CI] 0.31, 0.17-0.55), pneumothorax (0.48, 0.26-0.87), change of endotracheal tube (0.17, 0.07-0.44), atelectasis (0.37, 0.20-0.68) and death in the ICU (0.82, 0.69-0.97).CONCLUSIONS:
A multifaceted program including strategic planning, organizational culture imprint and care protocols was associated with a significant reduction of adverse events in the respiratory-ICU.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Unidades de Cuidados Respiratórios
/
Planejamento Estratégico
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Cultura Organizacional
/
Pacotes de Assistência ao Paciente
Tipo de estudo:
Guideline
/
Observational_studies
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Prevalence_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article