Safety practices in mechanical ventilation in patients in Intensive Care Units of the city of Medellín, Colombia, in the year 2018

Objective: To determine the compliance to patient safety measures in adult patients receiving mechanical ventilation in different Intensive Care Units (ICU) in Medellín, Colombia, during 2018. Methods: Observational, descriptive, cross-sectional and multicentre study. Information was collected from registers and medical files of adult patients in the ICU who were receiving mechanical ventilation. Data was entered in Excel sheets, and univariate and bivariate analyses were performed. Results: The highest compliance to the standards was 91.8% and the lowest was 64.3%. Ventilation associated Pneumoniae prevention measures were fulfilled in the majority of cases. Hand washing was performed in 82.43% of the cases. Adequate endotracheal tube cuff pressure was observed in 67 patients, and 6 received sub-glottic suction. Less than half (44.59%) of patients were sedated between −1 and 2 on the RASS scale, and 58.1% were awakened daily. The bed head elevation was adequate in 77.1%. Oral hygiene and prophylaxis was carried out on more than 85% of the patients. The large majority (91.89%) had a suitable plateau pressure to prevent lung injury. The average PEEP was 7.54 cmH2O, established according to ARMA in 47.3% and to Pressure-Volume curves in 2.7%. Tidal volume was inadequate in 48 (64.86%) patients. The sedation and analgesia protocol was accomplished in 70 (94.6%) patients. Conclusion: Despite de fact that the established criteria are mostly fulfilled, there is still a great opportunity to improve the safety of the patients who receive mechanical ventilation in the ICU in the city of Medellín.