Table 4.
Distribution of evaluated patients for every measure and improvement proportion related to the AASTRE (IPR-AASTRE)
| Evaluated patients (IPR-AASTRE, %) Total |
Evaluated patients (IPR-AASTRE, %) Quarter 1 |
Evaluated patients (IPR-AASTRE, %) Quarter 2 |
Evaluated patients (IPR-AASTRE, %) Quarter 3 |
p | |
|---|---|---|---|---|---|
| Block 1. Mechanical ventilation | |||||
| 1. Alveolar pressure limit | 124 (26.6) | 71 (26.8) | 20 (45.0) | 33 (15.2) | 0.12 |
| 2. Mechanical ventilation alarms | 398 (31.2) | 155 (34.2) | 119 (33.6) | 124 (25.0) | 0.001 |
| 3. Tolerance to spontaneous ventilation | 175 (1.1) | 59 (1.7) | 56 (0.0) | 60 (1.7) | 0.62 |
| 4. Suitable current volume | 336 (1.5) | 17 (2.6) | 107 (0.9) | 112 (0.9) | 0.47 |
| Block 2. Haemodynamics | |||||
| 5. Monitor alarms | 557 (21.5) | 223 (23.3) | 142 (23.9) | 192 (17.7) | <0.0001 |
| 6. Water balance and fluid adjustment | 557 (1.1) | 223 (0.5) | 142 (0.7) | 192 (2.8) | 0.36 |
| 7. Adequate haemodynamic monitoring | 556 (0.4) | 223 (0.0) | 141 (0.7) | 192 (0.5) | 0.49 |
| 8. Fluid therapy and amines adjustment according to monitoring | 93 (1.1) | 40 (0.0) | 19 (0.0) | 34 (2.9) | 0.41 |
| Block 3. Renal function and CRRT | |||||
| 9. Acute renal failure assessment | 654 (11.8) | 280 (14.6) | 160 (10.6) | 214 (8.9) | 0.03 |
| 10. CRRT treatment prescription | 27 (3.7) | 13 (0.0) | 6 (0.0) | 8 (12.5) | 0.29 |
| 11. CRRT monitoring | 28 (0.0) | 14 (0.0) | 6 (0.0) | 8 (0.0) | Not calculable |
| Block 4. Sedation/analgesia | |||||
| 12. Evaluation of sedation level and pain of sedated patient | 199 (11.6) | 86 (15.1) | 61 (9.8) | 52 (7.7) | 0.30 |
| 13. Pain assessment in non-sedated patient | 396 (8.6) | 137 (13.1) | 110 (5.5) | 149 (6.7) | 0.19 |
| 14. Oversedation prevention | 132 (9.8) | 65 (10.8) | 42 (2.4) | 25 (20.0) | 0.16 |
| Block 5. Treatment (1) | |||||
| 15. Check drug allergies and intolerances in patient’s medical history | 623 (4.8) | 268 (4.1) | 161 (6.8) | 194 (1.6) | 0.10 |
| 16. Correct prescription of daily treatment orders | 623 (4.8) | 268 (5.6) | 161 (4.9) | 194 (3.6) | 0.66 |
| 17. Adequate indication and dosage of the prescribed medication | 622 (3.9) | 268 (4.9) | 160 (3.8) | 194 (2.6) | 0.37 |
| 18. Prescribed treatment administered correctly. Verbal orders | 623 (1.9) | 268 (3.4) | 161 (0.0) | 194 (1.6) | <0.0001 |
| Block 6. Treatment (2) | |||||
| 19. Prevention of thromboembolic disease | 549 (4.9) | 249 (7.2) | 146 (3.4) | 154 (2.6) | 0.04 |
| 20. Prophylaxis of gastrointestinal haemorrhage | 587 (0.3) | 266 (0.4) | 159 (0.0) | 162 (0.6) | 0.63 |
| 21. Control of hyperglycaemia | 588 (1.4) | 264 (1.5) | 160 (1.3) | 164 (1.2) | 0.85 |
| 22. Assessment of the antibiotic treatment | 436 (2.3) | 195 (3.1) | 119 (0.8) | 122 (2.5) | 0.43 |
| 23. Appropriate transfusion | 554 (0.2) | 233 (0.0) | 157 (0.6) | 164 (0.0) | 0.49 |
| Block 7. Techniques and tests | |||||
| 24. Checking of X-ray slides | 539 (1.5) | 186 (1.6) | 165 (2.4) | 188 (0.5) | 0.34 |
| 25. Daily assessment of the need for catheters | 624 (16.8) | 225 (16.0) | 183 (19.7) | 216 (15.3) | 0.46 |
| Block 8. Nutrition | |||||
| 26. Monitoring of enteral nutrition | 487 (24.6) | 241 (27.0) | 117 (27.4) | 129 (17.8) | 0.11 |
| 27. Daily assessment by parenteral nutrition team | 78 (23.1) | 24 (4.2) | 25 (24.0) | 29 (37.9) | 0.04 |
| Block 9. Nursing care | |||||
| 28. Verification of endotracheal tube cuff pressure | 436 (0.5) | 195 (0.0) | 127 (0.8) | 114 (0.9) | 0.58 |
| 29. Oral hygiene with chlorhexidine (0.12–0.2%) | 476 (0.4) | 217 ((0.5) | 138 (0.7) | 121 (0.0) | 0.52 |
| 30. Daily assessment of the risk of developing pressure ulcers | 563 (12.3) | 282 (18.1) | 151 (6.6) | 130 (6.2) | <0.0001 |
| 31. Daily assessment of the protective measures for the safe handling of the patient | 557 (1.1) | 281 (1.1) | 148 (1.4) | 128 (0.8) | 0.47 |
| 32. Semi-recumbent position | 433 (21.7) | 196 (20.9) | 123 (24.4) | 114 (20.2) | 0.48 |
| Block 10. Structure | |||||
| 33. Unequivocal patient identification | 594 (12.5) | 243 (14.4) | 190 (12.1) | 161 (9.9) | 0.42 |
| 34. Patient clinical information properly structured in the medical history | 592 (24.8) | 243 (26.3) | 189 (29.1) | 160 (17.5) | 0.06 |
| 35. Life-sustaining treatment limit sheet updated | 82 (9.8) | 30 (10.0) | 22 (4.5) | 30 (13.3) | 0.44 |
| 36. Correct position of bed rails | 584 (0.3) | 240 (0.8) | 185 (0.0) | 159 (0.0) | 0.24 |
| 37. Information to family members | 592 (0.2) | 242 (0.4) | 189 (0.0) | 161 (0.0) | 0.46 |
CRRT continuous renal replacement techniques