[Impact of quality-indicator-based measures to improve the treatment of acute poisoning in pediatric emergency patients].

Autor:	Martínez Sánchez L; Servicio de Urgencias, Hospital Sant Joan de Déu-Barcelona, España., Trenchs Sainz de la Maza V; Servicio de Urgencias, Hospital Sant Joan de Déu-Barcelona, España., Azkunaga Santibáñez B; Servicio de Urgencias, Hospital Universitario de Cruces, Coordinadora del Grupo de Trabajo de Intoxicaciones de la Sociedad Española de Urgencias de Pediatría, España., Nogué-Xarau S; Unidad de Toxicología Clínica. Hospital Clínic. Barcelona, España., Ferrer Bosch N; Servicio de Urgencias, Hospital Sant Joan de Déu-Barcelona, España., García González E; Servicio de Urgencias, Hospital Sant Joan de Déu-Barcelona, España., Luaces I Cubells C; Servicio de Urgencias, Hospital Sant Joan de Déu-Barcelona, España.
Jazyk:	Spanish; Castilian
Zdroj:	Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias [Emergencias] 2016 Feb; Vol. 28 (1), pp. 31-37.
Abstrakt:	Objectives: To analyze the impact of quality-indicator-based measures for improving quality of care for acute poisoning in pediatric emergency departments. Material and Methods: Recent assessments of quality indicators were compared with benchmark targets and with results from previous studies. The first study evaluated 6 basic indicators in the pediatric emergency departments of members of to the working group on poisoning of the Spanish Society of Pediatric Emergency Medicine (GTI-SEUP). The second study evaluated 20 indicators in a single emergency department of GTI-SEUP members. Based on the results of those studies, the departments implemented the following corrective measures: creation of a team for gastric lavage follow-up, preparation of a new GTI-SEUP manual on poisoning, implementation of a protocol for poisoning incidents, and creation of specific poisoning-related fields for computerized patient records. Results: The benchmark targets were reached on 4 quality indicators in the first study. Improvements were seen in the availability of protocols, as indicators exceeded the target in all the pediatric emergency departments (vs 29.2% of the departments in an earlier study, P < .001). No other significant improvements were observed. In the second study the benchmarks were reached on 13 indicators. Improvements were seen in compliance with incident reporting to the police (recently, 44.4% vs 19.2% previously, P = .036), case registration in the minimum basic data set (51.0% vs 1.9%, P < .001), and a trend toward increased administration of activated carbon within 2 hours (93.1% vs 83.5%, P = .099). No other significant improvements were seen. Conclusion: The corrective measures led to improvements in some quality indicators. There is still room for improvement in these emergency departamens' care of pediatric poisoning.
Databáze:	MEDLINE
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