Background Real time safety auditing (RTSA) has not been widely used in hospitals. There is insufficient information on its use as a tool for patient safety.
Aim To determine the frequency of appropriate use of the security systems in technological equipment for monitoring and respiratory support through RTSA. To estimate whether the characteristics of the patient, time or location influence the frequency of appropriate use.
Methods Prospective observational study conducted during 2012 in a tertiary NICU. 115 days were randomly selected. Two monitoring or respiratory devices were randomly selected each study day. Information about time, location and patient characteristics was collected. Appropriate use was defined as all evaluated items correctly programmed on the same device.
Results A total of 94 pulse oximeter, 104 multi-measurement monitor, 53 conventional ventilator, 64 high frequency oscillatory ventilator and 68 CPAP audits were performed. Kappa coefficient of inter-observer agreement was 0.93. Audits revealed appropriate use of equipment in 33.68% of cases. During non-working days it was 43.02% compared to 30.98% on working days (p 0.03). During afternoon shifts it was 38.65% compared to 30% on morning shifts (p 0.07). Patient characteristics, location and month did not have a significant influence. In the adjusted analysis the OR of appropriate use for non-working days was 1.85 (1.11–3.06) and for afternoon shifts 1.59 (1.03–2.47).
Conclusions Frequency of appropriate use of security systems in the equipment surveyed was low. Surprisingly, when there are fewer doctors in the unit (non-working days and afternoons) the use of technology improves.