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2015, Number 4

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Med Crit 2015; 29 (4)

Implementation of the mnemonic keyword «Calidad» to decrease the morbidity of patients in intensive care units at the hospitals of the Sistema Tec Salud

Aceves VED, Mauricio HFJ, Pérez RFJ, Sánchez NVM

Language: Spanish
References: 34
Page: 222-233
PDF size: 247.38 Kb.


ABSTRACT

Introduction: Omission mistakes are a frequent cause of avoidable complications in Medicine. Critically ill patients, due to their complexity, are more vulnerable to these. Several checklists have been developed to decrease the omission mistakes in the Critical Care Unit and by doing so, decrease also the complications related to them. To the date, there are not checklists developed in a Mexican Critical Care Unit.
Objective: We propose the use of the acronym «Calidad» (C is for Catheters, A for feeding (Alimentación) and glycemic control, L for skin and Lesions, I for head position (Inclinación), D for pain/consciousness/delirium (Dolor), A is for Airway and D for thrombosis Development) as a tool to decrease omissions and the incidence of complications in critically ill patients.
Patients and methods: This was a longitudinal, cohort study to compare the impact of the application of this checklist in the compliance of the most basic general care variables of critically ill patients at their Critical Care Unit admission. We included patients over 18 years of age, critically ill and hospitalized in the Critical Care Units of two private Hospitals. The control group consisted of the hospitalized patients from June to October of 2012 and the study group (after the application of «Calidad») the same months but of 2013. A descriptive analysis and a comparison between groups in terms of variable compliance and complication incidence were made. We used Chi square and Fisher tests.
Results: Our sample consisted of 87 patients. 35 were hospitalized in 2012 and 51 in 2013. There were no demographic differences between groups. The compliance of the feeding variable increased from 34.2 to 70.5% (p ‹ 0.001). The skin lesions went from 20 to 68.6% (p ‹ 0.001) and finally the thrombosis development variable rose from 54.2 to 76.4% (p = 0.031). The complication that showed the most significant decrease was the incidence of pressure ulcers from 22.8 to 1.96% (p = 0.001).
Discussion and conclusions: The use of the «Calidad» checklist at their Critical Care Unit admission increased the compliance of all the variables mentioned in the acronym. This increase had a positive impact by decreasing the incidence of pressure ulcers.


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