title: Impact of an educational intervention on errors in death certification: An observational study from the intensive care unit of a tertiary care teaching hospital.
abstract: BACKGROUND
  A high incidence of errors occur while filling up death certificates in hospitals. The purpose of this study was to analyze the impact of an educational intervention on errors in death certification in an intensive care unit (ICU). Patients admitted to ICUs by virtue of being critically ill have a higher mortality than other hospitalized patients. This study was designed to see if any improvement could be brought about in filling death certificates.
  
  
  METHODS
  Educating sessions, interactive workshops, and monthly audits for the department resident doctors were conducted. One hundred and fifty death certificates were audited for major and minor errors (75 before and 75 after the educational intervention) over a period of 18 months. Fisher's exact test was applied to statistically analyze the data.
  
  
  RESULTS
  There was a significant decrease in major errors like mechanism without underlying cause of death (60.0 vs. 14.6%, P < 0.001), competing causes (88.0 vs. 13.3%, P < 0.001), and improper sequencing (89.3 vs. 36.0%, P < 0.001). There was also a significant decrease in minor errors such as use of abbreviations (89.3 vs. 29.3%, P < 0.001) and no time intervals (100.0 vs. 22.6%, P < 0.001).
  
  
  CONCLUSIONS
  Authors conclude that death certification errors can be significantly reduced by educational interventional programs.
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Afzal
authors.initials: A
authors.lastname: Azim
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Parikshit
authors.initials: P
authors.lastname: Singh
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Parmeet
authors.initials: P
authors.lastname: Bhatia
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Arvind K
authors.initials: AK
authors.lastname: Baronia
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Mohan
authors.initials: M
authors.lastname: Gurjar
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Banani
authors.initials: B
authors.lastname: Poddar
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Ratender K
authors.initials: RK
authors.lastname: Singh
keywords: Audit; death certification; educational intervention; errors