SICU Critical Care Safety Study

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shivabirdi

Health & Medicine Education

SICU Journal Club: The Critical Care Safety Study July 25, 2007 Christopher J. Utz, MD

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Methods ,[object Object],[object Object],[object Object],Patient population: MICU & CCU of 720 bed tertiary care hospital

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Results Data collected during nine 3-wk periods (5 in MICU, 4 in CCU) Observed 391 patients 420 admissions 1490 patient-days Patient demographics are different between MICU and CCU

Results ,[object Object],[object Object],[object Object],223 Serious errors – rate of 150 serious errors/1000 pt-days

Results ,[object Object],[object Object],24 serious errors judged to be potentially life-threatening

Results Incident Stats: Discovery of Adverse events & nonintercepted serious errors Patient’s nurse (36%) Another physician (27%) Clinical pharmacist (12%) Responsible physician (9%) Chart review (11%) Intercepted serious errors Patient’s nurse (42%) Another physician (23%) Clinical pharmacist (17%) ,[object Object],[object Object],[object Object]

Results 56 (47%) of adverse events due to ADE including 19 preventable ADE’s Medications contributed to 78% of serious errors Medication errors most commonly associated w/ treatment (87%) Also associated w/ prevention, diagnosis, & monitoring

Results Human & System Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Discussion Results comparable to prior MICU studies w/ similar definitions Error rates similar in MICU and CCU Most of the errors categorized as slips & lapses – failure to carry out intended plans of action Based on this study, the authors estimate that 148,000 life-threatening intercepted & nonintercepted serious errors occur annually in teaching hospitals ,[object Object],[object Object],[object Object]

Discussion Study limitations Primarily studied interns May not be generalizable to ICU’s w/ markedly different patient populations May not be generalizable to non-teaching ICU’s

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