scholarly journals Indicators of healthcare results: analysis of adverse events during hospital stays

2008 ◽  
Vol 16 (4) ◽  
pp. 746-751 ◽  
Author(s):  
Camila Cristina Pires Nascimento ◽  
Maria Cecília Toffoletto ◽  
Leilane Andrade Gonçalves ◽  
Walkíria das Graças Freitas ◽  
Katia Grillo Padilha
Keyword(s):  
Intensive Care ◽  
Adverse Events ◽  
Intensive Care Units ◽  
Medication Errors ◽  
Nursing Interventions ◽  
Similar Distribution ◽  
Nasogastric Tubes ◽  
Hospital Stays ◽  
The Moment ◽  
Nursing Professionals

This quantitative, retrospective study aimed to characterize adverse events (AE) in Intensive Care Units (ICU), Semi-Intensive Care Units (SCU) and Inpatient Units (IU), regarding nature, type, day of the week and nursing professionals / patient ratio at the moment of occurrence; as well as to identify nursing interventions after the event and AE rates. The study was performed at a private hospital in the city of São Paulo, Brazil. Two hundred twenty-nine AE were notified. The predominant events were related to nasogastric tubes (NGT) (57.6%), followed by patient fall (16.6%) and medication errors (14.8%). The nursing professionals /patient ratio at the moment of the event was 1:2 for the ICU, 1:3 for the SCU and 1:4 for the IU. A similar distribution was observed for the other days of the week. The nursing interventions were: repositioning the NGT (83.2%) and communication of the occurrence to the physician in case of medication errors (47.6%) and falls (55.2%). The highest AE rate was related to NGT.

scholarly journals Association between professional qualification and adverse events in neonatal and pediatric intensive treatment units

2021 ◽  
Vol 42 ◽  
Author(s):  
Eliane Cristina Sanches Maziero ◽  
Elaine Drehmer de Almeida Cruz ◽  
Josemar Batista ◽  
Francine Taporosky Alpendre ◽  
Marilise Borges Brandão ◽  
...  
Keyword(s):  
Intensive Care ◽  
Prognostic Factors ◽  
Adverse Events ◽  
Continuing Education ◽  
Intensive Care Units ◽  
Medical Records ◽  
Pediatric Intensive Care ◽  
Pediatric Intensive Care Units ◽  
Trigger Tool ◽  
Nursing Professionals

ABSTRACT Objective: to verify the association between the qualification of nursing professionals and the occurrence of adverse events in neonatal and pediatric intensive care units. Method: Cross-sectional and evaluation study conducted in six intensive care units of five public hospitals in the state of Paraná, Brazil. Data was collected from April/2017 to January/2018 through the use of a questionnaire to be completed by 143 nursing professionals and retrospective analysis of 79 medical records using the Neonatal Trigger Tool and Pediatric Trigger Tool instruments. The prognostic factors were professional training and the existence, or not, of a continuing education service; analysis was performed by logistic regression. Results: Detected 30 adverse events in 22 medical records analyzed. There was a prevalence of infection (n = 12; 40%) and skin damage (n = 9; 30%). Among the prognostic factors, continuing education was identified as a protective factor against adverse events (p≤0.05). Conclusion: Continuing education was associated with the prevention of adverse events in neonatal and pediatric intensive care units.

Clinical Predictors for Unsafe Direct Discharge Home Patients From Intensive Care Units

2018 ◽  
Vol 35 (10) ◽  
pp. 1067-1073
Author(s):  
Vincent Issac Lau ◽  
Fran Priestap ◽  
Joyce N. H. Lam ◽  
John Basmaji ◽  
Ian M. Ball
Keyword(s):  
Health Care ◽  
Substance Abuse ◽  
Intensive Care ◽  
Adverse Events ◽  
Intensive Care Units ◽  
Care Facility ◽  
Health Care Facility ◽  
Surgical Trauma ◽  
Home Discharge ◽  
Return Visits

Purpose: To describe factors (demographics and clinical characteristics) that predict patients who are at an increased risk of adverse events or unplanned return visits to a health-care facility following discharge direct to home (DDH) from intensive care units (ICUs). Methods: Prospective cohort study of all adult patients who survived their stay in our medical–surgical–trauma ICU between February 2016 and 2017 and were discharged directly home. Patients were followed for 8 weeks postdischarge. Univariable and multivariable logistic regression analyses were performed to identify factors associated with adverse events or unplanned return visits to a health-care facility following DDH from ICU. Results: A total of 129 DDH patients were enrolled and completed the 8-week follow-up. We identified 39 unplanned return visits (URVs). There was 0% mortality at 8 weeks postdischarge. Eight potential predictors of hospital URVs ( P < .2) were identified in the univariable analysis: prior substance abuse (odds ratio [OR] of URV of 2.50 [95% confidence interval: 1.08-5.80], hepatitis (OR: 6.92 [1.68-28.48]), sepsis (OR: 11.03 [1.19-102.29]), admission nine equivalents of nursing manpower score (NEMS) <24 (OR: 2.28 [1.03-5.04], no fixed address (OR: 22.9 [1.2-437.3]), ICU length of stay (LOS) <2 days (OR: 2.95 [1.28-6.78]), home discharge within London, Ontario (OR: 2.44 [1.00-5.92]), and left against medical advice (AMA; OR: 6.06 [2.04-17.98]). Conclusions: Our study identified 8 covariates that were potential predictors of URV: prior substance abuse, hepatitis, sepsis, admission NEMS <24, no fixed address, ICU LOS <2 days, home discharge within London, Ontario, and left AMA. The practice of direct discharges home from the ICU would benefit from adequately powered multicenter study in order to construct a clinical prediction model (that would require further testing and validation).

scholarly journals Assessment of patient safety culture in intensive care units and factors affecting it

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M A Tlili ◽  
W Aouicha ◽  
H Lamine ◽  
E Taghouti ◽  
M B e n Dhiab ◽  
...  
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Adverse Events ◽  
Intensive Care Units ◽  
Safety Culture ◽  
Improve Patient Safety ◽  
Healthcare Quality ◽  
Patient Safety Culture ◽  
Cross Sectional ◽  
Learning From Errors

Abstract Background The intensive care units are a high-risk environments for the occurrence of adverse events with serious consequences. The development of patient safety culture is a strategic focus to prevent these adverse events and improve patient safety and healthcare quality. This study aimed to assess patient safety culture in Tunisian intensive care units and to determine its associated factors. Methods It is a multicenter, descriptive cross-sectional study, among healthcare professionals of the intensive care units in the Tunisian center. The data collection was spread over a period of 2 months (October-November 2017). The measuring instrument used is the validated French version of the Hospital Survey On Patient Safety Culture questionnaire. Data entry and analysis was carried out by the Statistical Package for Social Sciences (SPSS 20.0) and Epi Info 6.04. Chi-square test was used to explore factors associated with patient safety culture. Results A total of 404 professionals participated in the study with a participation rate of 81.94%, spread over 10 hospitals and 18 units. All dimensions were to be improved. The overall perception of safety was 32.35%. The most developed dimension was teamwork within units with a score of 47.87% and the least developed dimension was the non-punitive response to error (18.6%). The patient safety culture was significantly more developed in private hospitals in seven of the 10 dimensions. Participants working in small units had a significantly higher patient safety culture. It has been shown that when workload is reduced the patient safety culture was significantly increased. Conclusions This study has shown that the patient safety culture still needs to be improved and allowed a clearer view of the safety aspects requiring special attention. Thus, improving patient safety culture. by implementing the quality management and error reporting systems could contribute to enhance the quality of healthcare provided to patients. Key messages The culture of culpability is the main weakness in the study. Encouraging event reporting and learning from errors s should be priorities in hospitals to enhance patient safety and healthcare quality.

scholarly journals Handwash versus hand-rub practices for preventing nosocomial infection in hospital intensive care units: A systematic review and meta-analysis

2020 ◽  
pp. 82-90
Author(s):  
S Bello ◽  
EA Bamgboye ◽  
DT Ajayi ◽  
EN Ossai ◽  
EC Aniwada ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intensive Care ◽  
Adverse Events ◽  
Nosocomial Infection ◽  
Intensive Care Units ◽  
Meta Analysis ◽  
Healthcare Providers ◽  
Length Of Hospital Stay ◽  
Clinical Effectiveness ◽  
Infection Rates

Background: Compliance with handwashing in busy healthcare facilities, such as intensive care units (ICUs), is suboptimal and alcohol hand-rub preparations have been suggested to improve compliance. There is no evidence on the comparative effectiveness between handwash and hand-rub strategies. This systematic review was to assess the effectiveness of handwash versus hand-rub strategies for preventing nosocomial infection in ICUs. Methods Studies conducted in ICUs and indexed in PubMed comparing the clinical effectiveness and adverse events between handwash and hand-rub groups were included in a systematic review. The primary outcome was nosocomial infection rates. Secondary outcomes included microbial counts on healthcare providers’ hands, mortality rates, patient/hospital cost of treatment of healthcare-associated infections (HCAIs), length of ICU/hospital stays, and adverse events. Studies were independently screened and data extracted by at least two authors. Meta-analyses of risk ratios (RR), incidence rate ratios (IRR), odds ratios (OR) and mean differences (MD), were conducted using the RevMan 5.3 software. Results: Seven studies published between 1992-2009 and involving a total of 11,663 patients were included. Five studies (10,981 patients) contributed data to the ICU acquired nosocomial infection rates. The pooled IRR was 0.71 (95% CI 0.61, 0.82; I2 = 94%). On sensitivity analysis, pooled IRR was 0.39 (95% CI 0.32, 0.48; 4 studies; 8,247 patients; I2 = 0%) in favour of hand rub. The pooled OR for mortality was 0.95 (95% CI 0.78, 1.61; 4 studies; 3,475 patients; I2 = 39%). The pooled MD for length of hospital stay was -0.74 (95% CI -2.83, 1.34; 3 studies; 741 patients; I2 = 0%). The pooled OR for an undesirable skin effect was 0.37 (95% CI 0.23, 0.60; 3 studies;1504 patients; I2 = 0%) in favour of hand rub. Overall quality of evidence was low. Conclusion: Hand rub appeared more effective when compared to handwash in ICUs.

scholarly journals Mortality assessment in intensive care units via adverse events using artificial neural networks

2006 ◽  
Vol 36 (3) ◽  
pp. 223-234 ◽  
Author(s):  
Álvaro Silva ◽  
Paulo Cortez ◽  
Manuel Filipe Santos ◽  
Lopes Gomes ◽  
José Neves
Keyword(s):  
Neural Networks ◽  
Artificial Neural Networks ◽  
Intensive Care ◽  
Adverse Events ◽  
Intensive Care Units ◽  
Artificial Neural

Prevalence of adverse events in pediatric intensive care units in the United States*

2010 ◽  
Vol 11 (5) ◽  
pp. 568-578 ◽  
Author(s):  
Swati Agarwal ◽  
David Classen ◽  
Gitte Larsen ◽  
Nancy M. Tofil ◽  
Leslie W. Hayes ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Adverse Events ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
The United States ◽  
Pediatric Intensive Care Units

scholarly journals Identifying medication errors in neonatal intensive care units: a two-center study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kaveh Eslami ◽  
Fateme Aletayeb ◽  
Seyyed Mohammad Hassan Aletayeb ◽  
Leila Kouti ◽  
Amir Kamal Hardani
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Medication Errors ◽  
Medical Records ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Neonatal Intensive Care Units ◽  
Preterm Neonates ◽  
Cross Sectional ◽  
Quality Of Prescribing

Abstract Background This study aimed to assess the types and frequency of medication errors in our NICUs (neonatal intensive care units). Methods This descriptive cross-sectional study was conducted on two neonatal intensive care units of two hospitals over 3 months. Demographic information, drug information and total number of prescriptions for each neonate were extracted from medical records and assessed. Results A total of 688 prescriptions for 44 types of drugs were checked for the assessment of medical records of 155 neonates. There were 509 medication errors, averaging (SD) 3.38 (+/− 5.49) errors per patient. Collectively, 116 neonates (74.8%) experienced at least one medication error. Term neonates and preterm neonates experienced 125 and 384 medication errors, respectively. The most frequent medication errors were wrong dosage by physicians in prescription phase [WU1] (142 errors; 28%) and not administering medication by nurse in administration phase (146 errors; 29%). Of total 688 prescriptions, 127 errors were recorded. In this regard, lack of time and/or date of order were the most common errors. Conclusions The most frequent medication errors were wrong dosage and not administering the medication to patient, and on the quality of prescribing, lack of time and/or date of order was the most frequent one. Medication errors happened more frequently in preterm neonates (P < 0.001). We think that using computerized physician order entry (CPOE) system and increasing the nurse-to-patient ratio can reduce the possibility of medication errors.

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