title: Auditing of Monitoring and Respiratory Support Equipment in a Level III-C Neonatal Intensive Care Unit.
abstract: BACKGROUND
  Random safety audits (RSAs) are a safety tool but have not been widely used in hospitals.
  
  
  OBJECTIVE
  To determine the frequency of proper use of equipment safety mechanisms in relation to monitoring and mechanical ventilation by performing RSAs. The study also determined whether factors related to the patient, time period, or characteristics of the area of admission influenced how the device safety systems were used.
  
  
  METHODS
  A prospective observational study was conducted in a level III-C Neonatal Intensive Care Unit (NICU) during 2012. 87 days were randomly selected. Appropriate overall use was defined when all evaluated variables were correctly programmed in the audited device.
  
  
  RESULTS
  A total of 383 monitor and ventilator audits were performed. The Kappa coefficient of interobserver agreement was 0.93. The rate of appropriate overall use of the monitors and respiratory support equipment was 33.68%. Significant differences were found with improved usage during weekends, OR 1.85 (1.12-3.06, p = 0.01), and during the late shift (3 pm to 10 pm), OR 1.59 (1.03-2.4, p = 0.03).
  
  
  CONCLUSIONS
  Equipment safety systems of monitors and ventilators are not properly used. To improve patient safety, we should identify which alarms are really needed and where the difficulties lie for the correct alarm programming.
authors.affiliation: Department of Neonatology, 12 de Octubre University Hospital, Biomedical Research Institute i+12, Madrid, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Bergon-Sendin
authors.affiliation: Department of Neonatology, 12 de Octubre University Hospital, Biomedical Research Institute i+12, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Perez-Grande
authors.affiliation: Department of Neonatology, 12 de Octubre University Hospital, Biomedical Research Institute i+12, Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Lora-Pablos
authors.affiliation: Department of Neonatology, 12 de Octubre University Hospital, Biomedical Research Institute i+12, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: De la Cruz Bertolo
authors.affiliation: Department of Neonatology, 12 de Octubre University Hospital, Biomedical Research Institute i+12, Madrid, Spain.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Moral-Pumarega
authors.affiliation: Department of Neonatology, 12 de Octubre University Hospital, Biomedical Research Institute i+12, Madrid, Spain.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Bustos-Lozano
authors.affiliation: Department of Neonatology, 12 de Octubre University Hospital, Biomedical Research Institute i+12, Madrid, Spain.
authors.forename: Carmen Rosa
authors.initials: CR
authors.lastname: Pallas-Alonso
mesh_terms: D054869:Clinical Audit; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000592:standards*; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000592:standards*; D061214:Patient Safety; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000592:standards*