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The neonatal preventable harm index: a high reliability tool.

T Murphy1, J Bender1, M Taub1

  • 1Women and Infants Hospital, Alpert Medical School of Brown University, Providence, RI, USA.

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|April 8, 2016
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Summary
This summary is machine-generated.

This study introduces the Neonatal Preventable Harm Index to track safety events in the neonatal intensive care unit (NICU). It identifies common harms like extubations and infiltrates, aiding in harm prevention strategies.

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Area of Science:

  • Neonatal intensive care
  • Patient safety
  • Healthcare quality improvement

Background:

  • Neonatal intensive care units (NICUs) face unique safety challenges.
  • Monitoring preventable harm is crucial for improving neonatal outcomes.
  • Existing safety indicators may not fully capture the spectrum of harm in the NICU.

Purpose of the Study:

  • To identify and quantify novel safety indicators for preventable harm in the NICU.
  • To develop a comprehensive index for monitoring NICU safety events.
  • To disseminate findings to guide harm prevention strategies.

Main Methods:

  • Literature review and expert experience in a level IV NICU.
  • Identification of prevalent, preventable safety events.
  • Negative binomial regression to analyze event incidence trends.

Main Results:

  • 226 preventable harm events were recorded between March 2013 and January 2015.
  • Unscheduled extubations (98 events) and intravenous infiltrates (62 events) were most common.
  • No significant trends in event rates were detected (rate ratio: 0.99).

Conclusions:

  • The Neonatal Preventable Harm Index offers a novel and transparent method for NICU safety monitoring.
  • This index can direct targeted harm prevention strategies.
  • Continuous monitoring is essential for maintaining and improving patient safety in the NICU.