Showing papers by "Joan Escarrabill published in 2006"
TL;DR: This study illustrates the current limitations of the quality control of HMV and suggests that improvements should be made to ensure adequate ventilator settings and correct ventilators performance and ventilATOR alarm operation.
Abstract: Background: Quality control procedures vary considerably among the providers of equipment for home mechanical ventilation (HMV). Methods: A multicentre quality control survey of HMV was performed at the home of 300 patients included in the HMV programmes of four hospitals in Barcelona. It consisted of three steps: (1) the prescribed ventilation settings, the actual settings in the ventilator control panel, and the actual performance of the ventilator measured at home were compared; (2) the different ventilator alarms were tested; and (3) the effect of differences between the prescribed settings and the actual performance of the ventilator on non-programmed readmissions of the patient was determined. Results: Considerable differences were found between actual, set, and prescribed values of ventilator variables; these differences were similar in volume and pressure preset ventilators. The percentage of patients with a discrepancy between the prescribed and actual measured main ventilator variable (minute ventilation or inspiratory pressure) of more than 20% and 30% was 13% and 4%, respectively. The number of ventilators with built in alarms for power off, disconnection, or obstruction was 225, 280 and 157, respectively. These alarms did not work in two (0.9%), 52 (18.6%) and eight (5.1%) ventilators, respectively. The number of non-programmed hospital readmissions in the year before the study did not correlate with the index of ventilator error. Conclusions: This study illustrates the current limitations of the quality control of HMV and suggests that improvements should be made to ensure adequate ventilator settings and correct ventilator performance and ventilator alarm operation.
51 citations
TL;DR: Lack of control and variability in the patterns of care among patients controlled by different types of physicians are common in moderate-to-severe COPD patients admitted for a COPD exacerbation, despite the lack of differences in COPD severity.
35 citations
TL;DR: Las reclamaciones recibidas por el servicio de urgencias de un hospital universitario de tercer nivel para plantear recomendaciones para reducir su incidencia son sobre cuestiones organizativas y por insatisfaccion with the asistencia.
Abstract: Resumen Introduccion Los servicios de urgencias hospitalarios (SUH) han sido concebidos para dar una respuesta optima a las necesidades del ciudadano. Objetivos En primer lugar, analizar las reclamaciones recibidas por el servicio de urgencias de un hospital universitario de tercer nivel para plantear recomendaciones para reducir su incidencia. En Segundo lugar, determinar si existe asociacion entre el tiempo de permanencia en urgencias y el numero de reclamaciones recibidas. Material y metodo Estudio descriptivo retrospectivo de las reclamaciones dirigidas al Servicio de Urgencias del Hospital Universitari de Bellvitge durante 13 anos consecutivos, entre el 1 de enero de 1992 y el 31 de diciembre de 2004. Se trata de un hospital con capacidad para 960 camas, que atiende anualmente a 110.381 individuos adultos por consultas urgentes, excluyendo la obstetricia. Resultados Durante los 13 anos estudiados, el SUH recibio un total de 1.610 reclamaciones, de las que el 19,7% (n = 317) fueron verbales y el 80,3% (n = 1.293), escritas. El 51,2% (n = 824) de los reclamantes fueron hombres. Los motivos mas frecuentes fueron demora excesiva para ser atendido en urgencias, con el 48,9% (n = 792), e insatisfaccion con la asistencia, con el 14,7% (n = 102). La tasa media de reclamaciones fue de 1,2 cada 1.000 visitas urgentes. Encontramos una asociacion moderada-intensa (rho de Spearman = 0,6; p Conclusiones La mayoria de las reclamaciones en un SUH son sobre cuestiones organizativas y por insatisfaccion con la asistencia. La informacion aportada por el analisis de las reclamaciones facilita la deteccion de oportunidades de mejora.
3 citations