Objective: To verify the causes of the not checking of the emergency car and the effect on the adherence rate by using quality tools in a Neonatal Intensive Care Unit. Method: mixed methods research of sequential exploratory design, developed with nurses and a documentary source in the Neonatal Intensive Care Unit of a university hospital, in three stages: 1) Brainstorming to survey the causes of not checking/ building a Checklist; 2) Data collection/analysis by applying the Pareto Checklist and Diagram; 3) Documentary analysis. The chi-square test was used to verify the effect of using quality tools in the adherence to checking. Results: 13 causes of not checking of the emergency car were identified, eight of which are preventable and five non-preventable. The preventable causes (n=63) represented 87.5%, the main ones being: lack of habit (n=17; 27%), prioritizing care activities (n=17; 27%), and dividing the care of patients / prioritize administrative activities (n=9; 14.3%). The application of quality tools had a significant effect (p-value <0.001) in the adherence to checking. Conclusion and implications for practice: the use of quality tools was feasible for the causal identification of the daily emergency car not checking and improvement in its adherence.

Keywords: Quality management; Quality of health care; Patient safety; Health management; Intensive care units, neonatal.