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Inventi Impact: Advanced Nursing

Articles

  • Inventi:han/31588/20
    Quality Indicators for Patients with Traumatic Brain Injury in European Intensive Care Units: A CENTER-TBI Study
    Research 2020 : July - September
    Jilske A Huijben, Eveline J A Wiegers, Ari Ercole, Nicolette F de Keizer, Andrew I R Maas, Ewout W Steyerberg, Giuseppe Citerio, Lindsay Wilson, Suzanne Polinder, Daan Nieboer, David Menon, Hester F Lingsma, Mathieu van der Jagt

    Background: The aim of this study is to validate a previously published consensus-based quality indicator set for\nthe management of patients with traumatic brain injury (TBI) at intensive care units (ICUs) in Europe and to study\nits potential for quality measurement and improvement.\nMethods: Our analysis was based on 2006 adult patients admitted to 54 ICUs between 2014 and 2018, enrolled in\nthe CENTER-TBI study. Indicator scores were calculated as percentage adherence for structure and process indicators\nand as event rates or median scores for outcome indicators. Feasibility was quantified by the completeness of the\nvariables. Discriminability was determined by the between-centre variation, estimated with a random effect regression\nmodel adjusted for case-mix severity and quantified by the median odds ratio (MOR). Statistical uncertainty of outcome\nindicators was determined by the median number of events per centre, using a cut-off of 10.\nResults: A total of 26/42 indicators could be calculated from the CENTER-TBI database. Most quality indicators proved\nfeasible to obtain with more than 70% completeness. Sub-optimal adherence was found for most quality indicators,\nranging from 26 to 93% and 20 to 99% for structure and process indicators. Significant (p < 0.001) between-centre\nvariation was found in seven process and five outcome indicators with MORs ranging from 1.51 to 4.14. Statistical\nuncertainty of outcome indicators was generally high; five out of seven had less than 10 events per centre.\nConclusions: Overall, nine structures, five processes, but none of the outcome indicators showed potential for quality\nimprovement purposes for TBI patients in the ICU. Future research should focus on implementation efforts and\ncontinuous reevaluation of quality indicators.\nTrial registration: The core study was registered with ClinicalTrials.gov, number NCT02210221, registered on August\n06, 2014, with Resource Identification Portal (RRID: SCR_015582).\nKeywords: Quality indicators, Benchmarking, Traumatic brain injuries, Intensive care units, Quality of health care

    How to Cite this Article
    Attribution/ CC Compliant Citation: Huijben, Jilske A., et al.\n\"Quality indicators for patients with traumatic brain injury in\nEuropean intensive care units: a CENTER-TBI study.\" Critical\nCare 24.1 (2020): 1-12.\nhttps://doi.org/10.1186/s13054-020-2791-0\nhttp://creativecommons.org/licenses/by/4.0/\n\nSome formatting elements, header, footer, logos, dates and\npagination were modified while adapting this article.
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