Letter to the Editor
Improvement of the safety of a clinical process using failure mode and effects analysis: Prevention of venous thromboembolic disease in critically ill patients
Mejora en la seguridad de un proceso clínico utilizando el análisis modal de fallos y efectos: profilaxis de la enfermedad tromboembólica venosa en pacientes críticos
R. Viejo Moreno
, J.A. Sánchez-Izquierdo Riera, E. Molano Álvarez, J.A. Barea Mendoza, S. Temprano Vázquez, L. Díaz Castellano, J.C. Montejo González
Corresponding author
Servicio de Medicina Intensiva, UCI Polivalente, Hospital 12 de Octubre, Madrid, Spain
Read
4850
Timeswas read the article
2293
Total PDF
2557
Total HTML
Share statistics
array:24 [ "pii" => "S2173572718300079" "issn" => "21735727" "doi" => "10.1016/j.medine.2018.01.003" "estado" => "S300" "fechaPublicacion" => "2018-03-01" "aid" => "1036" "copyright" => "Elsevier España, S.L.U. and SEMICYUC" "copyrightAnyo" => "2017" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Intensiva. 2018;42:135-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1289 "formatos" => array:3 [ "EPUB" => 181 "HTML" => 636 "PDF" => 472 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S021056911730058X" "issn" => "02105691" "doi" => "10.1016/j.medin.2017.01.006" "estado" => "S300" "fechaPublicacion" => "2018-03-01" "aid" => "1036" "copyright" => "Elsevier España, S.L.U. y SEMNIM" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Intensiva. 2018;42:135-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1722 "formatos" => array:3 [ "EPUB" => 205 "HTML" => 852 "PDF" => 665 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Mejora en la seguridad de un proceso clínico utilizando el análisis modal de fallos y efectos: profilaxis de la enfermedad tromboembólica venosa en pacientes críticos" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "135" "paginaFinal" => "136" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Improvement of the safety of a clinical process using failure mode and effects analysis: Prevention of venous thromboembolic disease in critically ill patients" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. Viejo Moreno, J.A. Sánchez-Izquierdo Riera, E. Molano Álvarez, J.A. Barea Mendoza, S. Temprano Vázquez, L. Díaz Castellano, J.C. Montejo González" "autores" => array:7 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "Viejo Moreno" ] 1 => array:2 [ "nombre" => "J.A." "apellidos" => "Sánchez-Izquierdo Riera" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Molano Álvarez" ] 3 => array:2 [ "nombre" => "J.A. Barea" "apellidos" => "Mendoza" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "Temprano Vázquez" ] 5 => array:2 [ "nombre" => "L." "apellidos" => "Díaz Castellano" ] 6 => array:2 [ "nombre" => "J.C." "apellidos" => "Montejo González" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173572718300079" "doi" => "10.1016/j.medine.2018.01.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572718300079?idApp=WMIE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021056911730058X?idApp=WMIE" "url" => "/02105691/0000004200000002/v1_201802250513/S021056911730058X/v1_201802250513/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173572718300018" "issn" => "21735727" "doi" => "10.1016/j.medine.2018.01.001" "estado" => "S300" "fechaPublicacion" => "2018-03-01" "aid" => "967" "copyright" => "Elsevier España, S.L.U. and SEMICYUC" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Intensiva. 2018;42:137" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1599 "formatos" => array:3 [ "EPUB" => 205 "HTML" => 880 "PDF" => 514 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Intensive Medicine</span>" "titulo" => "Fulminant sepsis caused by <span class="elsevierStyleItalic">Clostridium perfringens</span>" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "137" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Sepsis fulminante por <span class="elsevierStyleItalic">Clostridium perfringens</span>" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 350 "Ancho" => 867 "Tamanyo" => 73284 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Guridi Mugica, L. Marti Gelonch, R. Jimenez Agüero" "autores" => array:3 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Guridi Mugica" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Marti Gelonch" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Jimenez Agüero" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210569116301772" "doi" => "10.1016/j.medin.2016.08.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569116301772?idApp=WMIE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572718300018?idApp=WMIE" "url" => "/21735727/0000004200000002/v1_201803150431/S2173572718300018/v1_201803150431/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173572718300080" "issn" => "21735727" "doi" => "10.1016/j.medine.2018.01.004" "estado" => "S300" "fechaPublicacion" => "2018-03-01" "aid" => "1047" "copyright" => "Elsevier España, S.L.U. and SEMICYUC" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Intensiva. 2018;42:134-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1144 "formatos" => array:3 [ "EPUB" => 166 "HTML" => 558 "PDF" => 420 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Comparative statistical analysis in observational epidemiological studies" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "134" "paginaFinal" => "135" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Análisis estadísticos comparativos en los estudios epidemiológicos observacionales" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Bosch-Gaya, L. Matute-Blanco, D. Fernández-Rodríguez, F. Worner" "autores" => array:4 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Bosch-Gaya" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Matute-Blanco" ] 2 => array:2 [ "nombre" => "D." "apellidos" => "Fernández-Rodríguez" ] 3 => array:2 [ "nombre" => "F." "apellidos" => "Worner" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210569117300694" "doi" => "10.1016/j.medin.2017.02.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569117300694?idApp=WMIE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572718300080?idApp=WMIE" "url" => "/21735727/0000004200000002/v1_201803150431/S2173572718300080/v1_201803150431/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Improvement of the safety of a clinical process using failure mode and effects analysis: Prevention of venous thromboembolic disease in critically ill patients" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "135" "paginaFinal" => "136" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "R. Viejo Moreno, J.A. Sánchez-Izquierdo Riera, E. Molano Álvarez, J.A. Barea Mendoza, S. Temprano Vázquez, L. Díaz Castellano, J.C. Montejo González" "autores" => array:7 [ 0 => array:4 [ "nombre" => "R." "apellidos" => "Viejo Moreno" "email" => array:1 [ 0 => "rviejo@yahoo.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "J.A." "apellidos" => "Sánchez-Izquierdo Riera" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Molano Álvarez" ] 3 => array:2 [ "nombre" => "J.A." "apellidos" => "Barea Mendoza" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "Temprano Vázquez" ] 5 => array:2 [ "nombre" => "L." "apellidos" => "Díaz Castellano" ] 6 => array:2 [ "nombre" => "J.C." "apellidos" => "Montejo González" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Medicina Intensiva, UCI Polivalente, Hospital 12 de Octubre, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Mejora en la seguridad de un proceso clínico utilizando el análisis modal de fallos y efectos: profilaxis de la enfermedad tromboembólica venosa en pacientes críticos" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In the first place, we would like to thank you for your interest in our work. The goal of this work was to use the methodology from the Modal Analysis of Errors and Effects and implement a series of measures in order to improve this process and optimize the patient's safety (PS) on everything that has to do with the venous thromboembolic disease (VTED). One of these measures was the implementation of a 2014 protocol that was not fully developed in our paper because it was not the main goal of our work. However, while we were developing such protocol, seven special situations were established, among them, the management of renal failure (RF) that suggested the adjustment of enoxaparin based on the creatinine clearance (CrCl) rate, and according to the recommendations established by the Spanish Agency of Medicine and Medical Devices, and the Spanish Society of Hospital Pharmacy.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> At the same time, if the patient remained under continuous renal replacement therapy, the same dose than without RF was used since no bioaccumulation has been confirmed so far.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> Even so, we rather measure the concentrations of the anti-factor Xa as a safety measure because even though it has some limitations such as the absence of a clear correlation between the levels of anti-Xa and adverse events, or the poorly-established range of prophylactic levels, until these issues are resolved, it is still the best tool we have today to assess the effect of low-molecular-weight heparin (LMWH).</p><p id="par0010" class="elsevierStylePara elsevierViewall">Enoxaparin was the only LMWH used in our study, which is the usual practice in 90 per cent of the intensive care units (ICU) in Madrid and nationwide, where enoxaparin and bemiparin are used in 95.2 per cent of ICUs.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Such a decision may be triggered by a lack of evidence favoring one particular molecule over another in terms of effectiveness. All the indications for enoxaparin have already been approved as its technical label confirms and, in these cases, we can reduce its dose as long as we follow the guidelines for VTED prevention and those from the very paper they mention. Also, while enoxaparin; dalteparin; tinzaparin; or nadroparin are comparable, they are not interchangeable, require different doses and use different units of measurement. This may be problematic when it comes to PS, which is precisely what the Medication Errors Reporting Program claimed after confirming deaths of patients, due to confusion when using different heparin molecules.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> Finally, there is still controversy on issues such as bioaccumulation, and recent studies have concluded that the prophylactic use of enoxaparin in patients with CrCl rates ≤30<span class="elsevierStyleHsp" style=""></span>ml/min<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> is safe.</p><p id="par0015" class="elsevierStylePara elsevierViewall">One of the characteristics of the ICU patient is his dynamicity. Just as we said in our work, another one of the measures for improvement suggested was the introduction of one daily PS checklist, and another bedside PS check-list, which is when we will proceed to adjust the VTED prevention measures.</p><p id="par0020" class="elsevierStylePara elsevierViewall">For all the aforementioned, and with the only goal of optimizing the safety of our patients, we believe that the strategy adopted is the right one based not only on the evidence available, but also on our own experience after the implementation of the protocol.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">Grants for the development of research projects awarded by The Healthcare Research Institute of Hospital 12 de Octubre, i+12, sponsored by AMGEN S.A.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Viejo Moreno R, Sánchez-Izquierdo Riera JA, Molano Álvarez E, Barea Mendoza JA, Temprano Vázquez S, Díaz Castellano L, et al. Mejora en la seguridad de un proceso clínico utilizando el análisis modal de fallos y efectos: profilaxis de la enfermedad tromboembólica venosa en pacientes críticos. Med Intensiva. 2018;42:135–136.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Establecimiento de un protocolo para el uso de la heparina en pacientes con características especiales" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N. Manresa Ramón" 1 => "M.D. Nájera Pérez" 2 => "M.A. Page del Pozo" 3 => "I. Sánchez Martínez" 4 => "M.M. Sánchez Catalicio" 5 => "V. Roldán Schilling" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Farm Hosp" "fecha" => "2014" "volumen" => "38" "paginaInicial" => "135" "paginaFinal" => "144" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24669899" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "In vitro and in vivo evaluation of enoxaparin removal by continuous renal replacement therapies with acrylonitrile and polysulfone membranes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Isla" 1 => "A.R. Gascón" 2 => "J. Maynar" 3 => "A. Arzuaga" 4 => "E. Corral" 5 => "A. Martín" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clinthera.2005.09.008" "Revista" => array:6 [ "tituloSerie" => "Clin Ther" "fecha" => "2005" "volumen" => "27" "paginaInicial" => "1444" "paginaFinal" => "1451" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16291417" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "PROF-ETEV study: prophylaxis of venous thromboembolic disease in critical care units in Spain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P. García-Olivares" 1 => "J.E. Guerrero" 2 => "P. Galdos" 3 => "D. Carriedo" 4 => "F. Murillo" 5 => "A. Rivera" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00134-014-3442-1" "Revista" => array:6 [ "tituloSerie" => "Intensive Care Med" "fecha" => "2014" "volumen" => "40" "paginaInicial" => "1698" "paginaFinal" => "1708" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25138229" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Cohen M. Hazard Alert! Action needed to avert fatal errors from concomitant use of heparin products. ISMP Medication safety Alert! February 21, 2001. [consulted 12 Dec 2016] Available in: <a id="intr0010" class="elsevierStyleInterRef" href="http://www.ismp.org/MSArticles/heparinalert.html">www.ismp.org/MSArticles/heparinalert.html</a>" ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Determining the safety of enoxaparin prophylaxis in critically ill patients with severe renal insufficiency – the PACER pilot study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L.A. Castellucci" 1 => "J. Shaw" 2 => "A. Giulivi" 3 => "C. Edwards" 4 => "M. Carrier" 5 => "R. Patel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Tromb Res" "fecha" => "2016" "volumen" => "144" "paginaInicial" => "69" "paginaFinal" => "71" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735727/0000004200000002/v1_201803150431/S2173572718300079/v1_201803150431/en/main.assets" "Apartado" => array:4 [ "identificador" => "64604" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004200000002/v1_201803150431/S2173572718300079/v1_201803150431/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572718300079?idApp=WMIE" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 4 | 7 |
| 2024 October | 42 | 53 | 95 |
| 2024 September | 40 | 27 | 67 |
| 2024 August | 47 | 35 | 82 |
| 2024 July | 38 | 31 | 69 |
| 2024 June | 37 | 36 | 73 |
| 2024 May | 40 | 26 | 66 |
| 2024 April | 57 | 37 | 94 |
| 2024 March | 42 | 21 | 63 |
| 2024 February | 42 | 41 | 83 |
| 2024 January | 49 | 35 | 84 |
| 2023 December | 35 | 44 | 79 |
| 2023 November | 33 | 33 | 66 |
| 2023 October | 29 | 29 | 58 |
| 2023 September | 15 | 37 | 52 |
| 2023 August | 21 | 15 | 36 |
| 2023 July | 26 | 28 | 54 |
| 2023 June | 18 | 21 | 39 |
| 2023 May | 32 | 31 | 63 |
| 2023 April | 34 | 21 | 55 |
| 2023 March | 35 | 27 | 62 |
| 2023 February | 33 | 30 | 63 |
| 2023 January | 23 | 23 | 46 |
| 2022 December | 38 | 49 | 87 |
| 2022 November | 38 | 41 | 79 |
| 2022 October | 43 | 33 | 76 |
| 2022 September | 29 | 34 | 63 |
| 2022 August | 34 | 41 | 75 |
| 2022 July | 29 | 38 | 67 |
| 2022 June | 28 | 28 | 56 |
| 2022 May | 25 | 30 | 55 |
| 2022 April | 26 | 52 | 78 |
| 2022 March | 34 | 56 | 90 |
| 2022 February | 29 | 36 | 65 |
| 2022 January | 26 | 34 | 60 |
| 2021 December | 37 | 49 | 86 |
| 2021 November | 33 | 42 | 75 |
| 2021 October | 43 | 76 | 119 |
| 2021 September | 25 | 37 | 62 |
| 2021 August | 17 | 39 | 56 |
| 2021 July | 17 | 17 | 34 |
| 2021 June | 23 | 29 | 52 |
| 2021 May | 48 | 42 | 90 |
| 2021 April | 93 | 75 | 168 |
| 2021 March | 96 | 26 | 122 |
| 2021 February | 48 | 33 | 81 |
| 2021 January | 30 | 19 | 49 |
| 2020 December | 31 | 15 | 46 |
| 2020 November | 28 | 18 | 46 |
| 2020 October | 21 | 28 | 49 |
| 2020 September | 44 | 16 | 60 |
| 2020 August | 24 | 16 | 40 |
| 2020 July | 28 | 27 | 55 |
| 2020 June | 29 | 12 | 41 |
| 2020 May | 16 | 11 | 27 |
| 2020 April | 16 | 12 | 28 |
| 2020 March | 14 | 15 | 29 |
| 2020 February | 25 | 35 | 60 |
| 2020 January | 26 | 23 | 49 |
| 2019 December | 26 | 19 | 45 |
| 2019 November | 16 | 30 | 46 |
| 2019 October | 26 | 14 | 40 |
| 2019 September | 28 | 27 | 55 |
| 2019 August | 26 | 18 | 44 |
| 2019 July | 26 | 23 | 49 |
| 2019 June | 15 | 16 | 31 |
| 2019 May | 37 | 30 | 67 |
| 2019 April | 9 | 16 | 25 |
| 2019 March | 21 | 26 | 47 |
| 2019 February | 20 | 25 | 45 |
| 2019 January | 23 | 31 | 54 |
| 2018 December | 57 | 17 | 74 |
| 2018 November | 54 | 64 | 118 |
| 2018 October | 83 | 24 | 107 |
| 2018 September | 33 | 10 | 43 |
| 2018 August | 25 | 7 | 32 |
| 2018 July | 37 | 13 | 50 |
| 2018 June | 32 | 14 | 46 |
| 2018 May | 1 | 0 | 1 |
Show all
