El IECS works together with other institutions to generate knowledge that contributes to improving the Quality of the medical attention and patient safety adapted to the context. With this purpose, the first initiative has been Goodbye Bacteriaemias, with Latin American scope, a subsequent series of similar projects whose latest example is the study COST.
Collaborative initiatives over the last 10 years
- Goodbye Bacteriaemias
- Agod pneumonia
- Avoiding UPP
- Studio 5C
- COST
- Other experiences
The Department of Healthcare Quality and Patient Safety is a member of the initiative CLICSCS, Latin American Consortium for Innovation, Quality and Health Safety. Together with the Consortium, we are part of the strategic and operational group that led the campaign to prevent healthcare-associated infections in critical care units.
The international initiativeGoodbye bacteremia: Increasing the Impact' Its objective is to reduce the incidence of bacteremia associated with central venous catheter (BACVC) in Intensive Care Units (ICUs) in Latin America.
It was launched on September 28, 2012 with the aim of reducing the rate of bacteremia associated with central venous catheters (BACVC) in intensive care units in Latin America by 50%.
Ventilator-associated pneumonia (VAP) is one of the most prevalent IACS, resulting in high morbidity and mortality. These affect even patients admitted to an intensive care unit (ICU) with an incidence between 10–20 episodes per 1,000 days of mechanical ventilation in Latin America compared to a rate of 1.1 episodes in the United States.
VAPs are generally the result of a lack of compliance with health regulations and controls. However, it is possible to prevent them through the implementation of simple evidence-based interventions.
The international initiativeGoodbye Pneumonia: Eliminating Them is Possible' was launched in 2015, and its purpose is to reduce by 30% the incidence of pneumonia associated with mechanical ventilation (VAP) in intensive care units (ICUs) in Latin America through the implementation of a collaborative improvement project. of quality.
Under the premise that 95% of UPPs are avoidable, the campaign “Avoiding UPP” proposed an intervention of 7 measures considered as standards of care:
- Assess: establish the risk of developing PUs in each patient admitted to a critical area (ICU, ICU) of the summoned hospitals. Two main aspects: risk assessment and skin assessment.
- Classify: patients according to their risk with some standardized tool in the hospital (
- Inform: the patient and their family members about their risk assessment of developing pressure ulcers.
- Reposition: encourage repositioning every 4-6 hours; encourage and improve mobility and activity by providing necessary devices.
- Document: the affected surface area.
- Categorize: each ulcer according to a tool validated for its use (NPUAP scale – EPUAP 2009).
- Nourish: perform a nutritional assessment (MUST).
The benefits of collaborative experiences are: peer learning, improvement with standardized practices, the possibility of sharing discussion spaces with experts.
The IECS acted as a facilitator of the virtual space and the researchers in charge of developing the collaborative for a group of Argentine health organizations.
Collaborative to improve the Quality of care in Critical Care units during the COVID19 pandemic: Studio 5C
In the context of the pandemic triggered by SARS-CoV-2, a multifaceted intervention was carried out in 14 public sector intensive care units (ICUs) in Argentina. The study sought to improve the use of personal protective equipment (PPE), compliance with 9 key processes for patient safety (PS) through a daily goal sheet (HMD), and emotional support to the health team ( IS). The results revealed a significant increase in the appropriate use of PPE globally, with figures that went from 59% to 71.4%, (p<0.001). This increase was also observed both in contact with patients with COVID-19 (65.9% to 80.6%, p<0.001) and without COVID-19 (40.8% to 53.3%, p=0.013). HMD experienced an improvement, rising from 54.3% to 66.4% (p<0.001). The emotional impact on health personnel was measured through the EASE Test, but with only 6% participation.
The collaborative intervention, co-designed and based on an improvement model, has demonstrated concrete improvements in compliance with safety protocols and the appropriate use of PPE in the ICU environment, providing valuable lessons in a middle-income context during a crisis.
Quality improvement collaborative to Optimize the use of antibiotics in intensive care units in Argentina (COST: Collaborative study for Optimizing antimicrobial STewardship)
With the objective of improving the prescription, use and appropriateness of antimicrobials in intensive care units (ICU), a quality improvement collaborative (CMC) was implemented for 11 months, involving 9 public ICUs in Argentina.
The intervention consisted of an antibiotic optimization program (AOP), based on audits and feedback on antibiotic use, clinical guidelines, time off antibiotics, pharmaceutical interventions and education. The results revealed an increase in the severity of the patients during the intervention period, however, similar days of antibiotic treatment were maintained between the periods (IP 1112,2 and BP 1133,4). The adjusted daily dose decreased significantly in the intervention period (1193 vs 1301), demonstrating efficiency in antibiotic management. Highlighting an adequate antibiotic adjustment of 62% in the intervention period, compared to 45,3% in In the baseline period, a significant reduction in pneumonia and infections associated with urinary catheters due to multidrug-resistant organisms was evident. Additionally, an improvement in the WHO Infection Prevention and Control Assessment Framework was observed after the intervention.
- Collaborative Secure Transfer
- Collaborative discharge management in health institutions in Argentina
- Reduction of hospitalization times in selected pathologies
- Zero LPP Care