Always on the alert: Medication errors

Pizarro Calderón, A.G.; Pazó Sayos, L.; Lema Tomé, M.

doi:10.1016/j.redare.2021.05.002

array:24 ["pii" => "S2341192922000531" "issn" => "23411929" "doi" => "10.1016/j.redare.2021.05.002" "estado" => "S300" "fechaPublicacion" => "2022-03-01" "aid" => "1336" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "copyrightAnyo" => "2021" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2022;69:187-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0034935621001742" "issn" => "00349356" "doi" => "10.1016/j.redar.2021.05.004" "estado" => "S300" "fechaPublicacion" => "2022-03-01" "aid" => "1336" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Rev Esp Anestesiol Reanim. 2022;69:187-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "CARTA AL DIRECTOR" "titulo" => "Siempre alerta: errores de medicación" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "187" "paginaFinal" => "188" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Always on the alert: medication errors" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 894 "Ancho" => 1505 "Tamanyo" => 221639 ] ] "descripcion" => array:1 [ "es" => "Bomba epidural, sistema de infusión y etiquetas identificativas: amarillas para uso epidural y azules para uso intravenoso." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A.G. Pizarro Calderón, L. Pazó Sayos, M. Lema Tomé" "autores" => array:3 [ 0 => array:2 [ "nombre" => "A.G." "apellidos" => "Pizarro Calderón" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Pazó Sayos" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Lema Tomé" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341192922000531" "doi" => "10.1016/j.redare.2021.05.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192922000531?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935621001742?idApp=UINPBA00004N" "url" => "/00349356/0000006900000003/v1_202202240544/S0034935621001742/v1_202202240544/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2341192922000543" "issn" => "23411929" "doi" => "10.1016/j.redare.2021.05.003" "estado" => "S300" "fechaPublicacion" => "2022-03-01" "aid" => "1338" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2022;69:189" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "Letter to the Director" "titulo" => "Communication strategies in intensive care units: ISOBAR and SPIKES" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "189" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Estrategias de comunicación en las unidades de cuidados intensivos: ISOBAR y SPIKES" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Medina Gamero, M. Regalado Chamorro, C. Pizarro Moncada" "autores" => array:3 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Medina Gamero" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Regalado Chamorro" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Pizarro Moncada" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0034935621001778" "doi" => "10.1016/j.redar.2021.05.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935621001778?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192922000543?idApp=UINPBA00004N" "url" => "/23411929/0000006900000003/v1_202204280534/S2341192922000543/v1_202204280534/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2341192922000439" "issn" => "23411929" "doi" => "10.1016/j.redare.2022.02.003" "estado" => "S300" "fechaPublicacion" => "2022-03-01" "aid" => "1277" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2022;69:183-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Case report" "titulo" => "Intraventricular hemorrhage as complication after spinal surgery. Case report" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "183" "paginaFinal" => "186" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hemorragia intraventricular como complicación tras una cirugía espinal. Caso clínico" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2302 "Ancho" => 2504 "Tamanyo" => 418532 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Chest CT. A: Image showing obliteration of the cerebellar pontine angle with effacement of the cerebellar foliae in the context of cerebellar oedema (arrows). B: Cisternal obliteration (arrow) and decreased fourth ventricle size (arrow). C: Right intraventricular bleeding (arrow). D: Effacement of the cerebral sulci (arrows) and decreased size of both ventricles with poorly defined basal ganglia (arrows), suggestive of cerebral oedema." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "P. Sánchez Zamora, B. Gómez del Pulgar Vázquez, S. Gholamian Ovejero" "autores" => array:3 [ 0 => array:2 [ "nombre" => "P." "apellidos" => "Sánchez Zamora" ] 1 => array:2 [ "nombre" => "B." "apellidos" => "Gómez del Pulgar Vázquez" ] 2 => array:2 [ "nombre" => "S." "apellidos" => "Gholamian Ovejero" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0034935621000505" "doi" => "10.1016/j.redar.2020.12.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935621000505?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192922000439?idApp=UINPBA00004N" "url" => "/23411929/0000006900000003/v1_202204280534/S2341192922000439/v1_202204280534/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "Letter to the Director" "titulo" => "Always on the alert: Medication errors" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "187" "paginaFinal" => "188" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A.G. Pizarro Calderón, L. Pazó Sayos, M. Lema Tomé" "autores" => array:3 [ 0 => array:4 [ "nombre" => "A.G." "apellidos" => "Pizarro Calderón" "email" => array:1 [ 0 => "anagloriapizarro@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Pazó Sayos" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Lema Tomé" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Anestesiología y Reanimación, Hospital Gregorio Marañón, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Siempre alerta: errores de medicación" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1480 "Ancho" => 2507 "Tamanyo" => 525527 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Epidural pump, infusion system and identification labels: yellow for epidural use and blue for intravenous use." ] ] ] "textoCompleto" => "Safety in the workplace is an essential part of quality care. Anaesthesiologists have been aware of the potential risks and adverse events associated with their daily activity. Specifically, adverse events due to medication errors are a major problem that have not only economical but also human repercussions. The ENEAS study<a class="elsevierStyleCrossRef" href="#bib0005">1</a>, published in 2005, showed that 37.4% of adverse events that occur in relation to healthcare delivered in hospitals are due to medication errors.In 2010, the heads of the European anaesthesiology associations approved the Helsinki declaration on patient safety in anaesthesiology<a class="elsevierStyleCrossRef" href="#bib0010">2</a>. The document discusses medication errors and the need to be aware of errors in the medication preparation phases, to double check, and the need to protocolise these processes. The Joint Commission<a class="elsevierStyleCrossRef" href="#bib0015">3</a> and the Institute for Safe Medication Practices<a class="elsevierStyleCrossRef" href="#bib0020">4</a> have made their own recommendations for reducing administration errors.Errors in the preparation and administration of medication are very frequent (accounting for between 15% and 20% of incidents reported in our setting), and can be associated with morbidity. The platform most frequently used by anaesthesiologists to report these incidents is PITELO, available on the SENSAR website. We, as SENSAR analysts and members of our hospital’s Anaesthesiology and Resuscitation Safety Group, are responsible for receiving and analysing these notifications of critical incidents in order to prevent them from happening again. These are not isolated incidents or events exclusive to our hospital, but are repeated both nationally and internationally.Two events have prompted us to write this letter: the connection of an epidural PCA (patient-controlled analgesia) pump set to deliver 0.1% bupivacaine plus fentanyl to the peripheral line of 2 patients with epidural catheters. Both received intravenous boluses of this combination, but the attending nurses detected the error in time to prevent repercussions.After these incidents, which occurred in relatively quick succession, we analysed data from the SENSAR PITELO platform to determine the contributing factors and to propose corrective measures for each factor that would prevent these errors from recurring. We also performed a root cause analysis.In both cases, the PCA electronic prescription was correct and clearly specified the regimen and route of administration of the medication (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The medication was correctly identified and prepared using the specific systems for epidural administration, and stickers had been placed on both the proximal and distal ends of the lines to indicate that they were intended for epidural use. As shown in the image, the pumps, the infusion system, and the identification labels are yellow for epidural use and blue for intravenous (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Despite all the foregoing measures and existing safeguards, errors of this nature continue to occur, as shown by the incidents notified. This led us to wonder why these errors persist, and what additional measures can be put in place to prevent them.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia>We analysed the contributing factors using Reason’s Swiss cheese model, and came to the conclusion that the most important is the human factor, which is found in up to 50% of the critical incidents analysed. In this case, these human factors include:No safety culture: staff are unaware of the benefit of double checking, and do not correctly hand over patient information to their colleagues.Lack of attention, haste, work overload (particularly noticeable over this past year due to the pandemic), high staff turnover ratio.Absence of independent connection systems for intravenous and epidural lines that would prevent incorrect connections.This has prompted us to consider introducing new measures: new epidural systems with different connectors from those used in peripheral lines; medication error alerts that can be disseminated among staff; and periodic training sessions on the preparation and administration of drugs for all staff in all our units and wards, based, above all, on “the 10 correct procedures”<a class="elsevierStyleCrossRef" href="#bib0025">5</a>:Patient: unequivocally confirm identity with name, surname, date of birth, etc.Drug: read the label and the container until you are sure that it is the drug that has been prescribed.Route of administration: check that both the route of administration and pharmaceutical form are correct.Take into account the prescribed administration schedules.Check the dose and the patient who will receive the drug.Tell the patient or their legal guardians how to use the PCA, what the drug is for and its possible side effects. This will encourage them to become involved in their own treatment.Correctly reconstitute the drug, indicate type and volume, expiration date, and where it should be stored.Method and rate of administration.Record the administration of the drug.Monitor the patient’s response after administration.Patient safety in anaesthesiology spans the entire perioperative period, from the moment the patient attends the pre-anaesthesia consultation until he or she is discharged from the hospital. We, as anaesthesiologists, must ensure that safety standards are met and that new measures are implemented to prevent further errors. Tools such as surgical checklists are a clear example of how small gestures can improve patient safety. Aside from our work in the operating room, we also need to be involved in analysing all the untoward incidents that occur on a day-to-day basis and propose measures to prevent their recurrence. In this regard, incident reporting systems are valuable tools that can improve patient safety and quality of care by helping professionals learn from mistakes in a systematic way." "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Pizarro Calderón AG, Pazó Sayos L, Lema Tomé M. Siempre alerta: errores de medicación. Rev Esp Anestesiol Reanim. 2022. https://doi.org/10.1016/j.redar.2021.05.004" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1480 "Ancho" => 2507 "Tamanyo" => 525527 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Epidural pump, infusion system and identification labels: yellow for epidural use and blue for intravenous use." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sex \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ASA \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Where detected \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Surgery \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Detected by \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Prescription labelling protocol \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Effect on the patient \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Patient 1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">I \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ward \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gynaecology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nurse \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Correct \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">None \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Patient 2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Recovery unit \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Obstetrics \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nurse \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Correct \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">None \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2885773.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Description of incidents." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estudio nacional sobre los efectos adversos ligados a la hospitalización. ENEAS 2005" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.M. Aranaz" 1 => "C. Aibar" 2 => "J. Vitaller" 3 => "P. Ruiz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2006" "editorial" => "Ministerio de Sanidad y Consumo" "editorialLocalizacion" => "Madrid" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Helsinki declaration on patient safety in anaesthesiology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Mellin-Olsen" 1 => "S. Staender" 2 => "D.K. Whitaker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/EJA.0b013e32833b1adf" "Revista" => array:6 [ "tituloSerie" => "Eur J Anaesthesiol" "fecha" => "2010" "volumen" => "27" "paginaInicial" => "592" "paginaFinal" => "597" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20520556" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Patient controlled analgesia by proxy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Joint Commission on Accreditation of Healthcare Organizations" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Jt Comm Perspect" "fecha" => "2005" "volumen" => "25" "paginaInicial" => "10" "paginaFinal" => "11" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16764087" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Safety issues with patient-controlled analgesia. Part I: how errors occur" ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "ISMP Med Saf Alert" "fecha" => "2003" "volumen" => "8" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Safety issues with patient-controlled analgesia. Part II: how to prevent errors" ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "ISMP Med Saf Alert" "fecha" => "2003" "volumen" => "8" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23411929/0000006900000003/v1_202204280534/S2341192922000531/v1_202204280534/en/main.assets" "Apartado" => array:4 [ "identificador" => "66474" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letter to the Director" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23411929/0000006900000003/v1_202204280534/S2341192922000531/v1_202204280534/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192922000531?idApp=UINPBA00004N"]

ISSN: 2341-1929

Revista Española de Anestesiología y Reanimación (REDAR) -the Spanish Journal of Anesthesiology and Resuscitation- is the scientific body of the Spanish Society of Anesthesiology, Resuscitation and Pain Therapy. This is a monthly journal (10 issues) that publishes scientific articles of all areas within its specialty: clinical anesthesia, resuscitation-intensive medicine and critical care, diagnosis and treatment of acute and chronic pain, urgent care and emergencies and studies on basic science and related fields. The journal accepts work in both Spanish and English.

See more Open Access Option

Revista Española de Anestesiología y Reanimación has received its first journal Impact Factor (JCR) in 2023. Instructions for authors - Submit an article

Indexed in:

Web of Science, Emerging Sources Citation Index (WoS, Clarivate), PubMed/Medline, Scopus, EMBASE, IBECS

Subscribe:

Impact factor

The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years.

© Clarivate Analytics, Journal Citation Reports 2022

Impact factor 2023

0.9

Citescore

CiteScore measures average citations received per document published.

Citescore 2023

1.8

SJR

SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.

SJR 2023

0.239

SNIP

SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

SNIP 2023

362

View more metrics

Journal Information

Previous article | Next article

Vol. 69. Issue 3.