[Surveillance of health care errors. An overview of the published data in Argentina]. / Evidencia para mitigar errores en la práctica clínica y sanitaria. Una revisión de la literatura científica argentina.

In the last decades, public health surveillance extended its scope of study to new fields, such as medical errors, in order to improve patient safety. This study was aimed to review all the evidence produced in Argentina about the surveillance of medical errors. An exhaustive literature search was performed. A total of 4656 abstracts were assessed (150 MEDLINE, 145 LILACS, and 4361 hand searched abstracts). Of them, 52 were analysed and 8 were considered relevant for health care error surveillance. Different approaches were used to study medical errors. Some of them have focused on patient safety and others on medical malpractice. There is still a need to improve the surveillance of this type of event. Mainly, the quality reports of study design and surveillance attributes were unclear. A critical appraisal and synthesis of all relevant studies on health care errors may help to understand not only the state of the art, but also to define research priorities.

Evidencia para mitigar errores en la practica clinica y sanitaria: una revision de la literatura cientifica argentina / Surveillance of health care errors: an overview of the published data in Argentina

En las últimas décadas la vigilancia de la salud pública extendió su objeto de estudio hacia el desarrollo de estrategias que mejoren la seguridad del paciente a través de la notificación de los errores en medicina. El objetivo fue analizar las investigaciones publicadas en la Argentina acerca de sistemas diseñados para la vigilancia de los errores en el proceso de atención de los pacientes. Se realizaron búsquedaselectrónicas y una búsqueda manual de literatura. Se revisaron 4656 resúmenes, 150 de MEDLINE, 145 deLILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud) y 4361 de búsqueda manual. De ellos52 estudios fueron incluidos y 8 calificados como relevantes para la vigilancia del error. Los hallazgos mostraron que el enfoque del error en medicina y en particular su notificación es escasa y no está sistematizada. Unaexplicación probable sería el temor de los profesionales por la potencial demanda. La sistematización de la literatura científica es necesaria para acceder de manera eficiente al estado del conocimiento sobre el tema y ladefinición de prioridades en investigación

In the last decades, public health surveillance extended its scope of study to new fields, such as medical errors,in order to improve patient safety. This study was aimed to review all the evidence produced in Argentina aboutthe surveillance of medical errors. An exhaustive literature search was performed. A total of 4656 abstracts were assessed (150 MEDLINE, 145 LILACS, and 4361 hand searched abstracts). Of them, 52 were analysed and 8 were considered relevant for health care error surveillance. Different approaches were used to study medicalerrors. Some of them have focused on patient safety and others on medical malpractice. There is still a need toimprove the surveillance of this type of event. Mainly, the quality reports of study design and surveillance attributeswere unclear. A critical appraisal and synthesis of all relevant studies on health care errors may help to understand not only the state of the art, but also to define research priorities

Evidencia para mitigar errores en la practica clinica y sanitaria: una revision de la literatura cientifica argentina / Surveillance of health care errors: an overview of the published data in Argentina

En las últimas décadas la vigilancia de la salud pública extendió su objeto de estudio hacia el desarrollo de estrategias que mejoren la seguridad del paciente a través de la notificación de los errores en medicina. El objetivo fue analizar las investigaciones publicadas en la Argentina acerca de sistemas diseñados para la vigilancia de los errores en el proceso de atención de los pacientes. Se realizaron búsquedaselectrónicas y una búsqueda manual de literatura. Se revisaron 4656 resúmenes, 150 de MEDLINE, 145 deLILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud) y 4361 de búsqueda manual. De ellos52 estudios fueron incluidos y 8 calificados como relevantes para la vigilancia del error. Los hallazgos mostraron que el enfoque del error en medicina y en particular su notificación es escasa y no está sistematizada. Unaexplicación probable sería el temor de los profesionales por la potencial demanda. La sistematización de la literatura científica es necesaria para acceder de manera eficiente al estado del conocimiento sobre el tema y ladefinición de prioridades en investigación (AU)

In the last decades, public health surveillance extended its scope of study to new fields, such as medical errors,in order to improve patient safety. This study was aimed to review all the evidence produced in Argentina aboutthe surveillance of medical errors. An exhaustive literature search was performed. A total of 4656 abstracts were assessed (150 MEDLINE, 145 LILACS, and 4361 hand searched abstracts). Of them, 52 were analysed and 8 were considered relevant for health care error surveillance. Different approaches were used to study medicalerrors. Some of them have focused on patient safety and others on medical malpractice. There is still a need toimprove the surveillance of this type of event. Mainly, the quality reports of study design and surveillance attributeswere unclear. A critical appraisal and synthesis of all relevant studies on health care errors may help to understand not only the state of the art, but also to define research priorities (AU)

Evidencia para mitigar errores en la practica clinica y sanitaria: una revision de la literatura cientifica argentina / Surveillance of health care errors: an overview of the published data in Argentina

En las últimas décadas la vigilancia de la salud pública extendió su objeto de estudio hacia el desarrollo de estrategias que mejoren la seguridad del paciente a través de la notificación de los errores en medicina. El objetivo fue analizar las investigaciones publicadas en la Argentina acerca de sistemas diseñados para la vigilancia de los errores en el proceso de atención de los pacientes. Se realizaron búsquedaselectrónicas y una búsqueda manual de literatura. Se revisaron 4656 resúmenes, 150 de MEDLINE, 145 deLILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud) y 4361 de búsqueda manual. De ellos52 estudios fueron incluidos y 8 calificados como relevantes para la vigilancia del error. Los hallazgos mostraron que el enfoque del error en medicina y en particular su notificación es escasa y no está sistematizada. Unaexplicación probable sería el temor de los profesionales por la potencial demanda. La sistematización de la literatura científica es necesaria para acceder de manera eficiente al estado del conocimiento sobre el tema y ladefinición de prioridades en investigación (AU)

In the last decades, public health surveillance extended its scope of study to new fields, such as medical errors,in order to improve patient safety. This study was aimed to review all the evidence produced in Argentina aboutthe surveillance of medical errors. An exhaustive literature search was performed. A total of 4656 abstracts were assessed (150 MEDLINE, 145 LILACS, and 4361 hand searched abstracts). Of them, 52 were analysed and 8 were considered relevant for health care error surveillance. Different approaches were used to study medicalerrors. Some of them have focused on patient safety and others on medical malpractice. There is still a need toimprove the surveillance of this type of event. Mainly, the quality reports of study design and surveillance attributeswere unclear. A critical appraisal and synthesis of all relevant studies on health care errors may help to understand not only the state of the art, but also to define research priorities (AU)

Dying in the intensive care unit: collaborative multicenter study about forgoing life-sustaining treatment in Argentine pediatric intensive care units.

OBJECTIVE: Describe modes of death and factors involved in decision-making together with life support limitation (LSL) procedures. DESIGN: Prospective, descriptive, longitudinal, and noninterventional study. SETTING: Sixteen pediatric intensive care units in Argentina. PATIENTS: Every patient who died during a 1-yr period was included. MEASUREMENTS AND MAIN RESULTS: Age, sex, length of stay (LOS), primary and admission diagnosis, underlying chronic disease (CD), postoperative condition (PO). Deaths were classified in four groups: a) failed cardiopulmonary resuscitation (CPR); b) do-not-resuscitate (DNR) status; c) withholding or withdrawing life-sustaining treatment (WH/WD); and d) brain death (BD). Justifications were classified as a) imminent death; b) poor long-term prognosis; c) poor quality of life; and d) family request. Data were collected from medical records and interviews with the attending physicians. Descriptive statistics were performed. Differences among groups were analyzed through contingency tables and analysis of variance when required. Relative risks and confidence intervals of variables potentially related to LSL were analyzed, and logistic regression was performed. There were 6358 admissions and 457 deaths. CPR was performed in 52%, DNR in 16%, WH/WD in 20%, and BD in 11% of dead patients. BD patients were older, LOS and CD prevalence were higher in the WH/WD group. Inotropic drugs were the most frequently limited treatment in 110 patients (55%), CPR in 72 (35.6%), and mechanical ventilation in 63 (31%). Imminent death was the most frequently reported justification for LSL. CD and more staff were associated with a higher probability of LSL. CONCLUSIONS: Most of the patients in Argentina underwent CPR before their death. We have a high proportion of patients with CD (65%) and low BD diagnosis. PO condition decreased LSL probability in chronically ill patients. Do-not-resuscitate orders and withholding new treatments were the most common LSL. Active withdrawal was exceptional. The Ethics Committee was consulted in 5% of the LSL population.