Hernández-Borges Angel A, Pérez-Estévez Elena, Jiménez-Sosa Alejandro, Concha-Torre Andrés, Ordóñez-Sáez Olga, Sánchez-Galindo Amelia C, Murga-Herrera Vega, Balaguer-Gargallo Mónica, Nieto-Moro Montserrat, Pujol-Jover Montserrat, Aleo-Luján Esther
Research Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Pediatric Intensive Care Unit, Hospital Universitario Cruces, Bilbao, Spain; Pediatric Intensive Care Unit, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain; Pediatric Intensive Care Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario Gregorio Marañón, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitario de Salamanca, Salamanca, Spain; Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain; Pediatric Intensive Care Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Universitari de la Vall d'Hebron, Barcelona, Spain; and Pediatric Intensive Care Unit, Hospital Clínico San Carlos, Madrid, Spain.
Pediatr Qual Saf. 2017 Jan 16;2(1):e009. doi: 10.1097/pq9.0000000000000009. eCollection 2017 Jan-Feb.
This study objective was to identify, select, and define a basic set of quality indicators for pediatric intensive care in Spain.
(1) Review of the literature to identify quality indicators and their defining elements and (2) selection of indicators by consensus of a group of experts using basic Delphi methodology (2 rounds) and forms distributed by email among experts from the Spanish society of pediatric intensive care.
We selected quality indicators according to their relevance and feasibility and the experts' agreement on their incorporation in the final set. We included only those indicators whose assessment was within the highest tertile and greater than or equal to 70% evaluator agreement in the final selection. Starting from an initially proposed set of 136 indicators, 31 experts first selected 43 indicators for inclusion in the second round. Twenty indicators were selected for the final set. This "top 20" set comprised 9 process indicators, 9 of results (especially treatment-associated adverse effects), and 2 indicators of structure. Several of them are classical indicators in intensive care medicine (rates of hospital-acquired infections, pressure ulcers, etc.), whereas others are specifically pediatric (eg, unrestricted parent visitation or training the parents of technology-dependent children).
We reached a consensus on a set of 20 essential quality indicators for pediatric intensive care in Spain. A significant subset reflects the peculiarities of pediatric care. We consider this subset as a starting point for future projects of network collaboration between pediatric intensive care units in Spain.
本研究的目的是确定、选择并界定一套西班牙儿科重症监护的基本质量指标。
（1）回顾文献以确定质量指标及其定义要素；（2）采用基本德尔菲法（两轮），由一组专家达成共识来选择指标，并通过电子邮件向西班牙儿科重症监护协会的专家分发表格。
我们根据指标的相关性和可行性以及专家对将其纳入最终指标集的认可程度来选择质量指标。在最终选择中，仅纳入那些评估处于最高三分位数且评估者认可度大于或等于70%的指标。从最初提出的136项指标开始，31位专家首先在第二轮中选择了43项指标纳入。最终选定了20项指标。这一“前20”指标集包括9项过程指标、9项结果指标（尤其是与治疗相关的不良反应）和2项结构指标。其中一些是重症监护医学中的经典指标（医院获得性感染率、压疮发生率等），而其他一些则是儿科特有的指标（例如，无限制的家长探视或对依赖技术儿童的家长进行培训）。
我们就一套西班牙儿科重症监护的20项基本质量指标达成了共识。相当一部分指标反映了儿科护理的特殊性。我们认为这一部分指标是西班牙儿科重症监护病房未来网络合作项目的起点。
