Impact of quality-indicator-based measures to improve the treatment of acute poisoning in pediatric emergency patients
Martínez Sánchez L, Trenchs Sainz De La Maza V, Azkunaga Santibáñez B, Nogué-Xarau S, Ferrer Bosch N, García González E, Luaces I Cubells C
Affiliation of the authors
Servicio de Urgencias, Hospital Sant Joan de Déu-Barcelona, España. 2Servicio de Urgencias, Hospital Universitario de Cruces, Coordinadora del Grupo de Trabajo de Intoxicaciones de la Sociedad Española de Urgencias de Pediatría, Servicio de Urgencias, Hospital Sant Joan de Déu-Barcelona, Spain. Servicio de Urgencias, Hospital Universitario de Cruces, Coordinadora del Grupo de Trabajo de Intoxicaciones de la Sociedad Española de Urgencias de Pediatría, Spain. Unidad de Toxicología Clínica. Hospital Clínic. Barcelona, Spain. Unidad de Toxicología Clínica. Hospital Clínic. Barcelona, Spain.
Martínez Sánchez L, Trenchs Sainz De La Maza V, Azkunaga Santibáñez B, Nogué-Xarau S, Ferrer Bosch N, García González E, et al. Impact of quality-indicator-based measures to improve the treatment of acute poisoning in pediatric emergency patients. Emergencias. 2016;28:31-7
Summary
Objective.
To analyze the impact of quality-indicator-based measures for improving quality of care for acute poisoning in pediatric emergency departments.
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.
Conclusions.
The corrective measures led to improvements in some quality indicators. There is still room for improvement in these emergency departamens’ care of pediatric poisoning.
