Madrid, España
Murcia, España
Tudela, España
Cieza, España
Objetivo Analizar el uso de pruebas complementarias y su relación con incidentes de seguridad en servicios de urgencias hospitalarios.
Metodología Se analizó a 935 pacientes atendidos en 9 servicios de urgencia de la Región de Murcia. Fuente de datos para detección de los incidentes: la historia y los informes de Urgencia, observación presencial y encuesta telefónica a la semana del alta.
Análisis estadístico: se utilizaron la t de Student para variables cuantitativas, la chi al cuadrado para las cualitativas y el test de ANOVA.
Resultados Se utilizó catéter venoso periférico en 397 pacientes (42,4%; IC del 95%: 39,3-45,5%), con diferencias significativas entre centros (p < 0,01) (rango: 37-81,8%). Así mismo se ha comprobado que en 23,4% (IC del 95%: 19,2-27,6%) de los casos, no se utilizó la vía después de la primera extracción. Se solicitaron pruebas radiológicas a 351 pacientes (37,7% [IC del 95%: 34,6-40,8%]), con diferencias significativas entre centros (p < 0,01). Se detectó a 95 pacientes con incidentes: 10,2% (IC del 95%: 8,3-12,1%). Se ha evidenciado mayor proporción de incidentes de seguridad en los pacientes en que se ha usado catéter venoso periférico (12,8%) frente a los que no se ha usado (8,5%) (p = 0,03), en los que se ha pedido una radiografía (12,8%) frente a los que no (8,6%) (p = 0,04) y tuvieron mayor estancia los casos con incidente (media 248,9) frente a los que no (media 164,1’) (p< 0,001).
Conclusión Se constata la variabilidad entre centros y la relación del uso de catéter venoso periférico y pruebas radiológicas con la aparición de incidentes de seguridad en Urgencias.
Objective To analyse the use of complementary tests and their relationship with safety incidents in hospital emergency departments.
Methodology An analysis was performed on 935 patients seen in the 9 hospital emergency departments. The source of data used for the detection of incidents were: emergency department clinical record and reports, together with face-to-face observation in the department, plus a telephone survey of the patient or family member at one week after the care.
Statistical tests used: The Student t test for quantitative variables, Chi squared test for qualitative variables, and the ANOVA test.
Results A peripheral venous catheter was used in 397 patients (42.4% (95% CI; 39.3-45.5%)), with a variability with significant differences between hospitals (P<.01), with a range of use from 37% to 81.8%. It was also observed that in 23.4% (95% CI; 19.2-27.6%) of the cases, the catheter was not used after the first blood draw. Radiological tests were requested for 351 patients, 37.7% (95% CI; 34.6-40.8%), also with significant differences between hospitals (P<.01), ranging from 24.6 to 65, 1%. Incidents were detected in 95 (10.2%) patients (95% CI; 8.3-12.1%) in the all the study centres. A higher proportion of safety incidents have been observed in patients where peripheral venous catheter has been used (12.8%) than in those in whom they had not been used (8.5%) (P=.03), as well as in patients on whom an x-ray was requested (12.8%) compared to those who did not (8.64%) (P=.04). A longer stay was also observed in cases with an incident (mean 248.9 minutes) than in those where there were none (mean 164.1 minutes) (P<.001). No statistically significant differences were found in the other parameters studied.
Conclusion A relationship was observed between the use of a peripheral venous catheter (many of them without use) and radiological tests and the occurrence of safety incidents in the Emergency Departments.
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