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International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

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Paediatric intensive care 'do not do' recommendations in Spain: Selection by Delphi method.

Ángel A Hernández Borges¹, Alejandro Jiménez Sosa², Rosalía Pérez Hernández¹

¹UCIP, Servicio de Pediatría, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.

Anales De Pediatria

|December 12, 2022

Summary

Spanish pediatric intensive care experts identified 26 "do not do" recommendations to improve patient safety and clinical effectiveness. These guidelines aim to eliminate ineffective, unsafe, or inefficient practices in pediatric intensive care units.

Keywords:

Learning health systems Paediatric intensive care unit Patient safety Prevenciones cuaternarias Quaternary prevention Recomendaciones de "no hacer"Seguridad del paciente Sistema de aprendizaje en Salud Unidad de Cuidados Intensivos Pediátricos ‘do not do’ recommendations

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Area of Science:

Pediatric Intensive Care Medicine
Clinical Quality Improvement
Evidence-Based Practice

Background:

Healthcare practices can be ineffective, unsafe, or inefficient.
Scientific societies and health authorities develop 'do not do' recommendations (DNDRs) to address these issues.
There was a need for consensus-based DNDRs specific to pediatric intensive care in Spain.

Purpose of the Study:

To select a consensus set of 'do not do' recommendations for pediatric intensive care in Spain.
To identify and prioritize practices that should be avoided to enhance patient care quality.

Main Methods:

A two-phase approach was used: initial DNDR proposal gathering and Delphi method-based selection.
Practices were evaluated based on prevalence, risk severity, and modifiability.
Consensus was reached through iterative evaluations by working group members of the Spanish Society of Pediatric Intensive Care (SECIP).
The initial set of 182 DNDRs was reduced to 26 based on consensus evaluations.

Main Results:

A total of 182 potential DNDRs were initially proposed by 30 intensivists.
The Delphi method, involving 14 evaluators, narrowed down the recommendations to a final set of 26.
The selected DNDRs primarily focus on improving clinical effectiveness and patient safety in pediatric intensive care.

Conclusions:

A consensus-based set of DNDRs for Spanish pediatric intensive care was successfully established.
These recommendations provide guidance to avoid unsafe, inefficient, or ineffective practices.
The study outcomes are expected to contribute to improving the quality of clinical care in pediatric intensive care settings.