Abstract
Objective This study aimed to use real-time safety audits to establish whether preparation
of the equipment required for the stabilization and resuscitation of newborns in the
delivery room areas is adequate.
Study Design This was a descriptive, multicenter study performed at five-level III-A neonatal
units in Madrid, Spain. For 1 year, one researcher from each center performed random
real-time safety audits (RRTSAs), on different days and during different shifts, of
at least three neonatal stabilization areas, either in the delivery room or in the
operating room used for caesarean sections. Three factors in each area were reviewed:
the set-up of the radiant warmer, the materials, and medication available. The global
audit was considered without defect when no errors were detected in any of the audited
factors. Possible differences in the results were analyzed as a function of the study
month, day of the week, or shift during which the audit had been performed.
Results A total of 852 audits were performed. No defects were detected in any of the three
factors analyzed in the 534 (62.7%, 95% confidence interval [CI]: 59.3–65.9) cases.
Slight defects were detected in 98 (11.5%, 95% CI: 9.4–13.8) cases and serious defects
capable of producing adverse events in the newborn during resuscitation were found
in 220 (25.8%, 95% CI: 22.9–28.9) cases. No statistically significant differences
in the results were found according to the day of the week or time during which the
audits were performed. However, the percentage of RRTSAs without defect increased
as the study period progressed (first quarter 38.1% vs. the last quarter 84.2%; p < 0.001).
Conclusion The percentage of adequately prepared resuscitation areas was low. RRTSAs made it
possible to detect errors in the correct availability of the neonatal stabilization
areas and improved their preparation by preventing errors from being perpetuated over
time.
Key Points
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RRTSAs are a tool for improving clinical safety.
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The use of RRTSAs in perinatal care is very uncommon.
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RRTSAs improve the preparation of newborn CPR areas.
Keywords
safety audits - neonatal resuscitation - neonatal intensive care - patient safety
- newborn - delivery rooms
