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  • Measure Summary
  • NQMC:008529
  • Mar 2011

Nursing care: percentage of vascular catheters accidentally removed.

Quality indicators in critically ill patients. Madrid (Spain): Spanish Society of Intensive and Critical Care and Units Coronary (SEMICYUC); 2011. 185 p.

View the original measure documentation External Web Site Policy

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in May 2016.

Primary Measure Domain

Clinical Quality Measures: Outcome

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the percentage of vascular catheters accidentally removed.

Rationale

The aim of intensive care medicine is to provide critical patients with the healthcare that they need, ensuring the quality and safety of care. Intensive care medicine is one of the principal components of modern healthcare systems. There is an increasing demand for this resource, which involves high costs.

The quality of care has gradually come to be the central focus of healthcare, and in recent years patient safety has come to represent one of the key aspects of quality. In the case of intensive care medicine, this interest in quality is even more evident, not only because of its social and economic impact, but also because some of the dimensions involved in the quality of care of critical patients take on greater importance: critical patients are more vulnerable, access to critical care is more limited so efforts to distribute resources equitably are more important, scant scientific evidence is available, and the efficiency is limited.

The accidental removal of catheters directly affects the patient's safety; it increases the risk of complications, the staff's workload, and the length of stay (and thus costs for material and human resources).

Evidence for Rationale

Amo Priego MD, Carmona Monge FJ, Gómez Nieves I, Bonilla Zafra G, Gordo Vidal F. [Assessment of the efficacy of the implementation of an arterial cannulation protocol as quality assurance method]. Enferm Intensiva. 2004 Oct-Dec;15(4):159-64. PubMed External Web Site Policy

Arias-Rivera S, Sánchez-Sánchez MM, Sánchez-Izquierdo R, Gallardo-Murillo MJ, Santos-Díaz RI, Frutos-Vivar F. [Establishment of a nursing-driven sedation protocol: effect on the sedation level and accidental withdrawal of tubes and catheters]. Enferm Intensiva. 2008 Apr-Jun;19(2):71-7. PubMed External Web Site Policy

Carrión MI, Ayuso D, Marcos M, Paz Robles M, de la Cal MA, Alía I, Esteban A. Accidental removal of endotracheal and nasogastric tubes and intravascular catheters. Crit Care Med. 2000 Jan;28(1):63-6. PubMed External Web Site Policy

Goñi Viguria R, García Santolaya MP, Vázquez Calatayud M, Margall Coscojuela MA, Asiaín Erro MC. [Evaluation of care quality in the ICU through a computerized nursing care plan]. Enferm Intensiva. 2004 Apr-Jun;15(2):76-85. PubMed External Web Site Policy

Lorente L, Huidobro MS, Martín MM, Jiménez A, Mora ML. Accidental catheter removal in critically ill patients: a prospective and observational study. Crit Care. 2004 Aug;8(4):R229-33. PubMed External Web Site Policy

Quality indicators in critically ill patients. Madrid (Spain): Spanish Society of Intensive and Critical Care and Units Coronary (SEMICYUC); 2011. 185 p.

Primary Health Components

Nursing care; vascular catheter removal

Denominator Description

Number of vascular catheter days (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Number of vascular catheters accidentally removed (see the related "Numerator Inclusions/Exclusions" field)

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences
  • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal

Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

Unspecified

State of Use

Current routine use

Current Use

Internal quality improvement

Measurement Setting

Hospital Inpatient

Intensive Care Units

Professionals Involved in Delivery of Health Services

Nurses

Physicians

Least Aggregated Level of Services Delivery Addressed

Single Health Care Delivery or Public Health Organizations

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Age greater than or equal to 18 years

Target Population Gender

Either male or female

IOM Care Need

Getting Better

IOM Domain

Safety

Case Finding Period

Unspecified

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Institutionalization

Therapeutic Intervention

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Number of vascular catheter days

Population: All vascular catheter days in patients discharged who have spent more than 24 hours in the intensive care unit (ICU) during the period reviewed.

Exclusions
Patients admitted for less than 24 hours

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
Number of vascular catheters accidentally removed

Note:

  • Accidental catheter removal includes:
    • Removal by the patient
    • Removal by staff in performing a maneuver
    • Obstruction of the catheter
  • Inclusion criteria:
    • Central venous or arterial catheter (central or peripheral insertion)
    • Catheters inserted in the ICU or elsewhere

Exclusions
Unspecified

Numerator Search Strategy

Institutionalization

Data Source

Electronic health/medical record

Paper medical record

Type of Health State

Adverse Health State

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a lower score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

Internal time comparison

Prescriptive standard

Prescriptive Standard

Standard:

  • Arterial catheter: 15 catheters per 1000 days
  • Central venous catheter: 6 catheters per 1000 days

Evidence for Prescriptive Standard

Quality indicators in critically ill patients. Madrid (Spain): Spanish Society of Intensive and Critical Care and Units Coronary (SEMICYUC); 2011. 185 p.

Original Title

Accidental removal of vascular catheters.

Measure Collection Name

Quality Indicators in Critically Ill Patients

Measure Set Name

Nursing Care

Submitter

Spanish Society of Intensive and Critical Care and Units Coronary - Clinical Specialty Collaboration

Developer

Spanish Society of Intensive and Critical Care and Units Coronary - Clinical Specialty Collaboration

Funding Source(s)

Boehringer Laboratories

Composition of the Group that Developed the Measure

Work Group for Nursing (SEEIUC)

  • Rosa García Díez
  • Mar Sánchez Sánchez
  • Juan Carlos Muñoz Camargo
  • Mónica Vázquez Calatayud
  • Rosa Jam Gatell
  • Rosana Goñi Viguria
  • Emilia Romero de San Pío
  • Susana Arias Rivera
  • Alicia Robas Gómez
  • Juan Ángel Hernández
  • Susana Arias Rivera

Scientific Coordination:

  • Maria Cruz Martín Delgado
  • Jesús Blanco Varela
  • Lluís Cabré Pericas
  • Pedro Galdos Anuncibay
  • Federico Gordo Vidal

Financial Disclosures/Other Potential Conflicts of Interest

Unspecified

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2011 Mar

Measure Maintenance

Unspecified

Date of Next Anticipated Revision

2016 Jul

Measure Status

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in May 2016.

Source(s)

Quality indicators in critically ill patients. Madrid (Spain): Spanish Society of Intensive and Critical Care and Units Coronary (SEMICYUC); 2011. 185 p.

Measure Availability

Source available in English External Web Site Policy and Spanish External Web Site Policy from the Spanish Society of Intensive and Critical Care and Units Coronary (SEMICYUC) Web site.

For more information, contact SEMICYUC at Paseo de la Reina Cristina, 36, 4o D, Madrid, Spain; Phone: +34-91-502-12-13; Fax: +34-91-502-12-14; Web site: www.semicyuc.org External Web Site Policy; E-mail: secretaria@semicyuc.org.

NQMC Status

This NQMC summary was completed by ECRI Institute on March 20, 2014. The information was verified by the measure developer on April 25, 2014.

The information was reaffirmed by the measure developer on May 10, 2016.

Copyright Statement

This NQMC summary is based on the original measure, which is subject to the measure developer's copyright restrictions.

The Quality Indicators in Critically Ill Patients update 2011 can be used by any private or public body only for the purposes of research, clinical management, teaching and education, and will not be used for any other purpose. In all cases, full credit to the Spanish Society of Intensive Care Medicine (SEMICYUC) will be granted. The commercial use of the Quality Indicators in Critically Ill Patients update 2011 is explicitly forbidden.

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