[Evaluation of the vital emergency action plan at the Navarre Hospital (Spain)]. / Evaluación del plan de actuación ante la urgencia vital en el Hospital de Navarra.

INTRODUCTION: Healthcare organizations are placing great emphasis on the care of patients with cardiopulmonary arrest (CPA) since interventions based on the scientific evidence can decrease both the mortality rate and sequelae. Nevertheless, there are limited comprehensive assessments covering all the resources and interventions required when a vital emergency arises. OBJECTIVE: To evaluate the effectiveness of the vital emergency action plan at the Navarre Hospital by analyzing a panel of 70 indicators. MATERIAL AND METHODS: Structure and process indicators were assessed in 25 clinical units at the Navarre Hospital from April to June 2008. The structure and review process of CPR carts were analyzed, defibrillators were tested and 40 simulations involving 144 professionals were evaluated. RESULTS: Nonconformities were found in 86% of the indicators evaluated. The percentages of compliance in the indicators of structure ranged from 39.6% to 100%. In the evaluation of process, conformity ranged from 2.5% to 100%. The percentages of simulations meeting time standards varied between 17.5% and 45%. In 37.5% of the simulations, at least 50% of trained staff were present in the unit. In 32.3% of the simulations, the standard for the number of people in the unit who participated in the simulations was achieved. CONCLUSIONS: This study identified problems in the structure and process of a vital emergency action plan without, at this stage, evaluating patient outcomes.

Evaluación del plan de actuación ante la urgencia vital en el Hospital de Navarra / Evaluation of the vital emergency action plan at the Navarre Hospital (Spain)

Introducción: Las organizaciones sanitarias conceden mucha importancia a la atención del paciente que sufre una parada cardiorrespiratoria (PCR) ya que, si se atiende conforme a la evidencia científica, pueden disminuir tanto la tasa de mortalidad como las secuelas. No obstante, no es frecuente encontrar evaluaciones integrales de todo lo que una organización debe disponer y hacer ante una urgencia vital. Objetivo: Evaluar la efectividad del plan de que dispone el Hospital de Navarra ante la urgencia vital a través del análisis de un panel de 70 indicadores. Material y métodos: Se ha evaluado la estructura y el proceso en 25 unidades clínicas del hospital de abril a junio de 2008. Se analizaron en la estructura los carros de parada, y en proceso la revisión de los carros, la comprobación de los desfibriladores y la evaluación de 144 profesionales en 40 simulacros. Resultados: En el 86% de los indicadores evaluados se encontraron disconformidades. Los porcentajes de conformidad en los indicadores de estructura oscilaron entre el 39,6 y el 100%. En el proceso, los porcentajes de conformidad oscilaron entre el 2,5 y el 100%. Se cumplieron los estándares de tiempo en un 17,5-45% de los simulacros. En el 37,5% de los simulacros, al menos el 50% de las personas de la unidad estaban formadas. El número de personas que participaron respecto a las presentes en la unidad alcanzó el estándar en el 32,3% de los simulacros. Conclusiones: El estudio identificó problemas en la estructura y el proceso sin evaluar en esta etapa los resultados en los pacientes (AU)

Introduction: Healthcare organizations are placing great emphasis on the care of patients with cardiopulmonary arrest (CPA) since interventions based on the scientific evidence can decrease both the mortality rate and sequelae. Nevertheless, there are limited comprehensive assessments covering all the resources and interventions required when a vital emergency arises. Objective: To evaluate the effectiveness of the vital emergency action plan at the Navarre Hospital by analyzing a panel of 70 indicators. Material and methods: Structure and process indicators were assessed in 25 clinical units at the Navarre Hospital from April to June 2008. The structure and review process of CPR carts were analyzed, defibrillators were tested and 40 simulations involving 144 professionals were evaluated. Results: Nonconformities were found in 86% of the indicators evaluated. The percentages of compliance in the indicators of structure ranged from 39.6% to 100%. In the evaluation of process, conformity ranged from 2.5% to 100%. The percentages of simulations meeting time standards varied between 17.5% and 45%. In 37.5% of the simulations, at least 50% of trained staff were present in the unit. In 32.3% of the simulations, the standard for the number of people in the unit who participated in the simulations was achieved. Conclusions: This study identified problems in the structure and process of a vital emergency action plan without, at this stage, evaluating patient outcomes (AU)