Análisis causa-raíz de los factores vinculados a la muerte de recién nacidos internados en maternidades públicas de Argentina / Root cause analysis of factors related to the death of newborns hospitalized in public maternities in Argentina
Rev. argent. salud publica
; 1(3): 13-17, jun. 2010. tab, graf
Article
in Es
| LILACS
| ID: lil-674981
Responsible library:
AR392.1
RESUMEN
INTRODUCCIÓN:
Las tasas de mortalidad infantil y neonatal en Argentina tienen tendencia decreciente y las desigualdades entre regiones son notables. El 60% de las muertes en <1 año ocurre en el periodo neonatal, 57% de esas muertes son evitables.OBJETIVO:
analizar un conjunto de muertes neonatales a través de técnicas estandarizadas y Análisis de Causa-Raíz (ACR).MÉTODO:
estudio multicéntrico observacional de corte transversal. Se incluyeron los recién nacidos (RN) ≥ 500 grs que fallecieron ≤ 30 días entre 06/08 y 03/09 en 6 maternidades. La recolección de datos fue prospectiva multidimensional, próxima a la muerte, a partir de todos los actores, con marcación cronológica y evaluación de dimensiones institucional, recursos humanos, equipamiento, ambiente físico y factores externos. Se caracterizó al RN fallecido y un grupo asesor clasificó la muerte como inevitable o reducible.RESULTADOS:
se analizaron 369 muertes; las causas de internación fueron dificultad respiratoria (67,7%), malformaciones (16,2%), infecciones y asfixia perinatal (12%). La dimensión de recursos humanos fue la más frecuentemente relacionada con la muerte (59%), seguida por la institucional y organizacional (48%). La condición de derivación (OR 1,97; IC95% 1,01-3,83) y la presencia de complicaciones (OR 8,56; IC 95% 5,03-14,5) y edad >6 días (OR 2,04; IC95% 1,06-3,95) resultaron asociadas en forma independiente a la reducibilidad de la muerte neonatal.CONCLUSIONES:
la mayor parte de las muertes neonatales fueron reducibles. Resulta fundamental establecer estrategias de capacitación y fortalecimiento del recurso humano que asiste a esta población.ABSTRACT
BACKGROUND:
The infant and neonatal mortality rate in Argentina is decreasing but disparities between regions are notable and 60 per cent of the newborn deaths (NB) are preventable.OBJECTIVE:
to analyze a set of neonatal deaths through standardized techniques and root cause analysis (RCA). The RCA is a reactive tool to identify factors contributing to the occurrence of an unwanted event in search of system failures.Design:
multicentric observational cross-sectional study.METHOD:
NB ≥ 500grs who died ≤ 30 days in 20082009 in 6 maternity hospitals in Argentina were included. Data collection was multidimensional and close to the death with chronological analysis and assessment of dimension institutional, human resources, equipment, physical environment and external factors. Every NB was epidemiologically characterized and an advisory group classified death as inevitable or reducible.RESULTS:
369 deaths were analyzed; the main hospitalization causes were respiratory distress (67.7%), malformations (16.2%), infections and perinatal asphyxia (12%). The human resources dimension was the most frequently related to the death (59%), followed by the institutional and organizational (48%). 57.7% of deaths were classified as reducible. The neonatal transport condition (OR 1.97CI95% 1, 01-3, 83), the presence of complications (OR 8,56 CI95% 5,03-14,5) and age > 6 days (OR2 CI95% 1,06-3, 95) were associated with neonatal death reducibility independently.CONCLUSIONS:
most of neonatal deaths were reducible. It is essential to establish strategies for training and strengthening human resources that assist this population.Key words
Full text:
1
Collection:
01-internacional
Database:
LILACS
Main subject:
Infant Mortality
/
Underlying Cause of Death
/
Cross-Sectional Studies
/
Multivariate Analysis
/
Delivery of Health Care
/
Health Human Resource Training
/
Evaluation Studies as Topic
/
Health Planning
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Evaluation_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Determinantes_sociais_saude
/
Equity_inequality
Limits:
Humans
/
Infant
/
Newborn
Country/Region as subject:
America do sul
/
Argentina
Language:
Es
Journal:
Rev. argent. salud publica
Journal subject:
SAUDE PUBLICA
Year:
2010
Document type:
Article
Affiliation country:
Argentina