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Updated: Mar 8, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[Improving patient safety: Usefulness of safety checklists in a neonatal unit]
María Arriaga Redondo1, Ester Sanz López1, Ana Rodríguez Sánchez de la Blanca1
1Servicio de Neonatología, Hospital General Universitario Gregorio Marañón, Madrid, España.
Insights
Safety checklists in neonatal intensive care units (NICUs) effectively detect patient safety incidents, particularly medication errors. Healthcare professionals found the checklists useful, with many believing they prevented adverse events.
Area of Science:
- Neonatal intensive care
- Patient safety
- Healthcare quality improvement
Background:
- Neonatal units are high-risk environments for adverse events (AE) due to patient complexity.
- Existing safety tools are not fully implemented in neonatal care.
- Improved patient safety strategies are needed in neonatal settings.
Purpose of the Study:
- To design and implement a safety checklist in a neonatal intensive care unit (NICU).
- To evaluate the checklist's effectiveness in detecting patient safety incidents.
- To assess healthcare professionals' satisfaction with the checklist tool.
Main Methods:
- A quasi-experimental prospective study design.
- Implementation of a safety checklist in a NICU.
- Evaluation of checklist utility and healthcare professional satisfaction.
Main Results:
- Checklist compliance rate was 56.5%, detecting 4.03 incidents per patient.
- Medication-related incidents were most frequent, followed by alarm and monitor adjustments.
- 75% of professionals found the checklist useful; 68.75% believed it prevented AEs.
Conclusions:
- Safety checklists are valuable tools for identifying incidents in NICUs.
- Healthcare professionals in the NICU reported positive assessments of the checklist's utility.
- Checklists contribute to enhanced patient safety in neonatal care.
Introduction:
Due to the complexity and characteristics of their patients, neonatal units are risk areas for the development of adverse events (AE). For this reason, there is a need to introduce and implement some tools and strategies that will help to improve the safety of the neonatal patient. Safety check-lists have shown to be a useful tool in other health areas but they are not sufficiently developed in Neonatal Units.
Material And Methods:
A quasi-experimental prospective study was conducted on the design and implementation of the use of a checklist and evaluation of its usefulness for detecting incidents. The satisfaction of the health professionals on using the checklist tool was also assessed.
Results:
The compliance rate in the neonatal intensive care unit (NICU) was 56.5%, with 4.03 incidents per patient being detected. One incident was detected for every 5.3 checklists used. The most frequent detected incidents were those related to medication, followed by inadequate alarm thresholds, adjustments of the monitors, and medication pumps. The large majority (75%) of the NICU health professionals considered the checklist useful or very useful, and 68.75% considered that its use had managed to avoid an AE. The overall satisfaction was 83.33% for the professionals with less than 5 years working experience, and 44.4% of the professionals with more than 5 years of experience were pleased or very pleased.
Conclusion:
The checklists have shown to be a useful tool for the detection of incidents, especially in NICU, with a positive assessment from the health professionals of the unit.
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