Low-value clinical practices and harm caused by non-adherence to 'do not do' recommendations in primary care in Spain: a Delphi study

Objective: To determine the non-adherence to the primary care 'do not do' recommendations (DNDs) and their likelihood to cause harm. Design: Delphi study. Setting: Spanish National Health System. Participants: A total of 128 professionals were recruited (50 general practitioners [GPs], 28...

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Autores: Mira JJ, Caro Mendivelso J, Carrillo I, GONZÁLEZ, J., Olivera G, Pérez-Pérez P, Nebot C, Silvestre C, Agra Y, Fernandez A, Valencia-Martín JL, Ariztegui A, Aranaz J, SOBRINA Research Team
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Recursos:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p3088
Acesso em linha:https://fisabio.portalinvestigacion.com/publicaciones/3088
Access Level:acceso abierto
Palavra-chave:overuse
patient safety
quality assurance
primary care
Delphi technique
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spelling Low-value clinical practices and harm caused by non-adherence to 'do not do' recommendations in primary care in Spain: a Delphi studyMira JJCaro Mendivelso JCarrillo IGONZÁLEZ, J.Olivera GPérez-Pérez PNebot CSilvestre CAgra YFernandez AValencia-Martín JLAriztegui AAranaz JSOBRINA Research Teamoverusepatient safetyquality assuranceprimary careDelphi techniqueObjective: To determine the non-adherence to the primary care 'do not do' recommendations (DNDs) and their likelihood to cause harm. Design: Delphi study. Setting: Spanish National Health System. Participants: A total of 128 professionals were recruited (50 general practitioners [GPs], 28 pediatricians [PEDs], 31 nurses who care for adult patients [RNs] and 19 pediatric nurses [PNs]). Interventions: A selection of 27 DNDs directed at GPs, 8 at PEDs, 9 at RNs and 4 at PNs were included in the Delphi technique. A 10-point scale was used to assess whether a given practice was still present and the likelihood of it causing of an adverse event. Main outcome measure: Impact calculated by multiplying an event's frequency and likelihood to cause harm. Results: A total of 100 professionals responded to wave 1 (78% response rate) and 97 of them to wave 2 (97% response rate). In all, 22% (6/27) of the practices for GPs, 12% (1/8) for PEDs, 33% (3/9) for RNs and none for PNs were cataloged as frequent. A total of 37% (10/27) of these practices for GPs, 25% (2/8) for PEDs, 33% (3/9) for RNs and 25% (1/4) for PNs were considered as potential causes of harm. Only 26% (7/27) of the DNDs for GPs showed scores equal to or higher than 36 points. The impact measure was higher for ordering benzodiazepines to treat insomnia, agitation or delirium in elderly patients (mean = 57.8, SD = 25.3). Conclusions: Low-value and potentially dangerous practices were identified; avoiding these could improve care quality.OXFORD UNIV PRESS2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/3088INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CAREISSN: 13534505ISSNe: 14643677reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p30882026-06-11T12:45:17Z
dc.title.none.fl_str_mv Low-value clinical practices and harm caused by non-adherence to 'do not do' recommendations in primary care in Spain: a Delphi study
title Low-value clinical practices and harm caused by non-adherence to 'do not do' recommendations in primary care in Spain: a Delphi study
spellingShingle Low-value clinical practices and harm caused by non-adherence to 'do not do' recommendations in primary care in Spain: a Delphi study
Mira JJ
overuse
patient safety
quality assurance
primary care
Delphi technique
title_short Low-value clinical practices and harm caused by non-adherence to 'do not do' recommendations in primary care in Spain: a Delphi study
title_full Low-value clinical practices and harm caused by non-adherence to 'do not do' recommendations in primary care in Spain: a Delphi study
title_fullStr Low-value clinical practices and harm caused by non-adherence to 'do not do' recommendations in primary care in Spain: a Delphi study
title_full_unstemmed Low-value clinical practices and harm caused by non-adherence to 'do not do' recommendations in primary care in Spain: a Delphi study
title_sort Low-value clinical practices and harm caused by non-adherence to 'do not do' recommendations in primary care in Spain: a Delphi study
dc.creator.none.fl_str_mv Mira JJ
Caro Mendivelso J
Carrillo I
GONZÁLEZ, J.
Olivera G
Pérez-Pérez P
Nebot C
Silvestre C
Agra Y
Fernandez A
Valencia-Martín JL
Ariztegui A
Aranaz J
SOBRINA Research Team
author Mira JJ
author_facet Mira JJ
Caro Mendivelso J
Carrillo I
GONZÁLEZ, J.
Olivera G
Pérez-Pérez P
Nebot C
Silvestre C
Agra Y
Fernandez A
Valencia-Martín JL
Ariztegui A
Aranaz J
SOBRINA Research Team
author_role author
author2 Caro Mendivelso J
Carrillo I
GONZÁLEZ, J.
Olivera G
Pérez-Pérez P
Nebot C
Silvestre C
Agra Y
Fernandez A
Valencia-Martín JL
Ariztegui A
Aranaz J
SOBRINA Research Team
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv overuse
patient safety
quality assurance
primary care
Delphi technique
topic overuse
patient safety
quality assurance
primary care
Delphi technique
description Objective: To determine the non-adherence to the primary care 'do not do' recommendations (DNDs) and their likelihood to cause harm. Design: Delphi study. Setting: Spanish National Health System. Participants: A total of 128 professionals were recruited (50 general practitioners [GPs], 28 pediatricians [PEDs], 31 nurses who care for adult patients [RNs] and 19 pediatric nurses [PNs]). Interventions: A selection of 27 DNDs directed at GPs, 8 at PEDs, 9 at RNs and 4 at PNs were included in the Delphi technique. A 10-point scale was used to assess whether a given practice was still present and the likelihood of it causing of an adverse event. Main outcome measure: Impact calculated by multiplying an event's frequency and likelihood to cause harm. Results: A total of 100 professionals responded to wave 1 (78% response rate) and 97 of them to wave 2 (97% response rate). In all, 22% (6/27) of the practices for GPs, 12% (1/8) for PEDs, 33% (3/9) for RNs and none for PNs were cataloged as frequent. A total of 37% (10/27) of these practices for GPs, 25% (2/8) for PEDs, 33% (3/9) for RNs and 25% (1/4) for PNs were considered as potential causes of harm. Only 26% (7/27) of the DNDs for GPs showed scores equal to or higher than 36 points. The impact measure was higher for ordering benzodiazepines to treat insomnia, agitation or delirium in elderly patients (mean = 57.8, SD = 25.3). Conclusions: Low-value and potentially dangerous practices were identified; avoiding these could improve care quality.
publishDate 2019
dc.date.none.fl_str_mv 2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/3088
url https://fisabio.portalinvestigacion.com/publicaciones/3088
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv OXFORD UNIV PRESS
publisher.none.fl_str_mv OXFORD UNIV PRESS
dc.source.none.fl_str_mv INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE
ISSN: 13534505
ISSNe: 14643677
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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