Aplicación conjunta de diversas herramientas de calidad en la reanimación neonatal
- Roberto Ortiz-Movilla
- Rosa María Funes-Moñux
- Laura Domingo Domingo-Comeche
- Maite Beato-Merino
- Lucía Martínez-Bernat
- Ana Royuela-Vicente
- Enriqueta Román-Riechmann
- Miguel Ángel Marín-Gabriel
ISSN: 1695-4033, 1696-4608
Année de publication: 2022
Volumen: 97
Número: 6
Pages: 405-414
Type: Article
D'autres publications dans: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )
Résumé
Introduction In neonatal resuscitation, it is important to know whether the use of a combination of quality assessment tools has an impact on the preparation of the resuscitation bed and equipment, the correct performance of the procedure and the clinical outcomes of the most vulnerable neonates. Material and methods Multicentre, prospective, quasi-experimental interventional study in five level III-A neonatal units. In the pre- and post-intervention phases, both of which lasted 1 year, there were weekly random audits of the stabilization beds in the delivery room to assess their preparation. In the post-intervention phase, checklists, briefings and debriefings were used in the resuscitation of neonates delivered before 32 weeks. We compared the performance of the procedure and early post-resuscitation outcomes in the 2 periods. Results 852 audits were carried out in the pre-intervention period and 877 in the post-intervention period. There was a greater percentage of audits that did not identify defects in the second phase (63% vs 81%; P < .001). The first phase included 75 resuscitations and the second 48, out of which all the quality assessment tools had been used in 36 (75%). We did not find any differences in the main clinical variables during stabilization, although we observed a trend towards fewer technical problems during the procedure in the second period. Conclusions The use of random audits, checklists, briefings and debriefings in the resuscitation of newborns delivered before 32 weeks is feasible but has no impact on short-term clinical outcomes or correct performance of the procedure. Audits of neonatal resuscitation beds significantly improved their preparation.