Download PDF
Am J Perinatol 2022; 39(04): 361-368
DOI: 10.1055/s-0040-1715859
Original Article

Real-Time Safety Audits of Neonatal Delivery Room Resuscitation Areas: Are We Sufficiently Prepared?

Roberto Ortiz-Movilla
1   Pediatric Service, Neonatology Unit, Puerta de Hierro-Majadahonda University Hospital, Majadahonda, Madrid, Spain
,
Rosa M. Funes-Moñux
2   Pediatric Service, Neonatology Unit, Príncipe de Asturias University Hospital, Universidad Alcalá de Henares, Alcalá de Henares, Madrid, Spain
,
Laura Domingo-Comeche
3   Pediatric Service, Neonatology Unit, Fuenlabrada University Hospital, Fuenlabrada, Madrid, Spain
,
Lucía Martínez-Bernat
4   Pediatric Service, Neonatology Unit, Getafe University Hospital, Getafe, Madrid, Spain
,
Maite Beato-Merino
5   Pediatric Service, Neonatology Unit, Severo Ochoa University Hospital, Leganés, Madrid, Spain
,
Ana Royuela-Vicente
6   Biostatistics Unit, Puerta de Hierro Biomedical Research Institute, CIBERESP, Madrid, Spain
,
Enriqueta Román-Riechmann
7   Pediatric Service, Puerta de Hierro-Majadahonda University Hospital, Universidad Autónoma de Madrid, Majadahonda, Madrid, Spain
,
Miguel Á. Marín-Gabriel
8   Pediatric Service, Neonatology Unit, Puerta de Hierro-Majadahonda University Hospital, Universidad Autónoma de Madrid, Majadahonda, Madrid, Spain
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Objective This study aimed to use real-time safety audits to establish whether preparation of the equipment required for the stabilization and resuscitation of newborns in the delivery room areas is adequate.

Study Design This was a descriptive, multicenter study performed at five-level III-A neonatal units in Madrid, Spain. For 1 year, one researcher from each center performed random real-time safety audits (RRTSAs), on different days and during different shifts, of at least three neonatal stabilization areas, either in the delivery room or in the operating room used for caesarean sections. Three factors in each area were reviewed: the set-up of the radiant warmer, the materials, and medication available. The global audit was considered without defect when no errors were detected in any of the audited factors. Possible differences in the results were analyzed as a function of the study month, day of the week, or shift during which the audit had been performed.

Results A total of 852 audits were performed. No defects were detected in any of the three factors analyzed in the 534 (62.7%, 95% confidence interval [CI]: 59.3–65.9) cases. Slight defects were detected in 98 (11.5%, 95% CI: 9.4–13.8) cases and serious defects capable of producing adverse events in the newborn during resuscitation were found in 220 (25.8%, 95% CI: 22.9–28.9) cases. No statistically significant differences in the results were found according to the day of the week or time during which the audits were performed. However, the percentage of RRTSAs without defect increased as the study period progressed (first quarter 38.1% vs. the last quarter 84.2%; p < 0.001).

Conclusion The percentage of adequately prepared resuscitation areas was low. RRTSAs made it possible to detect errors in the correct availability of the neonatal stabilization areas and improved their preparation by preventing errors from being perpetuated over time.

Key Points

  • RRTSAs are a tool for improving clinical safety.

  • The use of RRTSAs in perinatal care is very uncommon.

  • RRTSAs improve the preparation of newborn CPR areas.

Keywords

safety audits - neonatal resuscitation - neonatal intensive care - patient safety - newborn - delivery rooms

Supplementary Material



Publication History

Received: 11 February 2020

Accepted: 23 July 2020

Article published online:
06 September 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA