American Journal of Nursing Science
Volume 3, Issue 6, December 2014, Pages: 100-104
Received: Jan. 28, 2014;
Accepted: Nov. 21, 2014;
Published: Nov. 25, 2014
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Hicham Bakkali, Department of Anesthesiology and Critical Care, Military Training Hospital Med V, Rabat, Morocco; Faculty of Medicine and Pharmacy, University Med V, Rabat, Morocco
Salahedine Massou, Department of Anesthesiology and Critical Care, Military Training Hospital Med V, Rabat, Morocco; Faculty of Medicine and Pharmacy, University Med V, Rabat, Morocco
Mohamed Moutaoukil, Department of Anesthesiology and Critical Care, Military Training Hospital Med V, Rabat, Morocco; Faculty of Medicine and Pharmacy, University Med V, Rabat, Morocco
Khalil Aboulaala, Department of Anesthesiology and Critical Care, Military Training Hospital Med V, Rabat, Morocco; Faculty of Medicine and Pharmacy, University Med V, Rabat, Morocco
Hicham Balkhi, Department of Anesthesiology and Critical Care, Military Training Hospital Med V, Rabat, Morocco; Faculty of Medicine and Pharmacy, University Med V, Rabat, Morocco
Charqui Haimeur, Department of Anesthesiology and Critical Care, Military Training Hospital Med V, Rabat, Morocco; Faculty of Medicine and Pharmacy, University Med V, Rabat, Morocco
Adverse events in an intensive care unit can raise important medical, ethical, legal and economic problems. This study aims at pointing out these adverse events, by assessing their severity, identifying the very risk factors associated with them, and comparing our results with existing evidence-based data. Material and methods: This is a retrospective study in the intensive care unit of the Military Hospital of Instruction Mohammed V, at RABAT, carried out over a period of 3 years and half. Included in the study are medical records of patients with an adverse event (AE) during their hospitalization in the IC (Intensive Care) or elsewhere, and who required a stay in Intensive care. We excluded nosocomial infections and adverse events due to medicated side effects, as there is no conclusive evidence of the accountability of the event to the product. Results: The study focuses on 813 patients. 44 patients experienced at least one adverse event, with an incidence of 5.4%. They were dominated by those of respiratory type (34%), followed by cardiovascular events and neurological disorders. All events were considered as preventable. The identified risk factors were due to human errors in 95% of cases: mainly, careless mistakes. The consequences of adverse events were of varying severity, with a mortality rate of 39% and a residence time of 12 days on average, comparable to those of other patients without iatrogenic complications. Conclusion: In our study, AE are dominated by events of respiratory type, and human error is the main associated factor. The specific impact of these events on prognosis is difficult to assess because they occur in serious situations. The monitoring of AE may constitute a care quality indicator.
A Study of Adverse Events in an Intensive Care Unit in Morocco, American Journal of Nursing Science.
Vol. 3, No. 6,
2014, pp. 100-104.
Smith DG, Wheeler JRC. Strategies and structures for hospital risk management programs. Health Care Manage Rev. 1992; 17:9-17.
Giraud T, Dhainaut JF, Vaxelaire JF, Joseph T, Journois D, Bleichner G, Sollet JP, Chevret S, Monsallier JF. Iatrogenic complications in adult intensive care units : a prospective two center study. Crit Care Med 1993; 21:40-51.
Bloomfield Rubins H, Moskowitz MA. Complications of care in a medical intensive care unit. J Gen Intern Med 1990 ; 5 :104-9.
Trunet P, Lhoste F, Le Gall JR, Rapin M. Iatrogenic disease occurring in an ICU (article in french). Rean Soins Intens Med Urg 1987; 3:15-18.
Steel K, Gertman PM, Crescenzic C, Anderson J. Iatrogenic illness on a general medical service at a university hospital. N Engl J Med 1981 ; 304 :638-42
Soufir L, Auroy Y. Field 2. Epidemiology (medical errors and patient adverse events). French-speaking society of intensive care. French society of anesthesia and resuscitation. Ann fr anesth rea 2008; 27: e59- 63.
Bouhaja B, Mermech M, Mestiri T, Ben Ayed M, Dhaouadi MZ, Ben Ammar M. Iatrogenic disease in the intensive care unit: a prospective study. Réanim Urgences 1999; 8: 319-26.
Donchin Y, Gopher D, Olin M, Badihi Y, Biesky M, Sprung C L, Pizov R, Cotev S. A look into the nature and causes of human errors in the intensive care unit. Qual Saf Health Care 2003; 12:143–148.
Darchy B, Le Mière E, Figueredo B, Bavoux E, Cadoux G, Domart Y. Patients admitted to the intensive care unit for iatrogenic disease. Risk factors and consequences. Rev Med Interne 1998; 19:470-8.
Survey ENEIS 2004 - DREES. Serious adverse events related to treatment observed in health facilities: First results of a national study. Corrected version. (article in French). 398, May 2005.
Rothschild JM, Landrigan CP, Cronin JW, Kaushal R, Lockley SW, Burdick E, Stone PH, Lilly CM, Katz JT, Czeisler CA, Bates DW.. The Critical Care Safety Study: The incidence and nature of adverse events and serious medical errors in intensive care. Crit Care Med 2005; 33: 1694-1700.
Trunet P, Le Gall JR, Lhoste F, Regnier B, Saillard Y,Carlet J, Rapin M. The role of iatrogenic disease in admissions to intensive care. JAMA 1980; 244: 2617-20.
Wilson RM, Runciman WB, Gibberd RW, Harrison BT,Newby L, Hamilton JD. The quality in Australian health care study. Med J Aust. 1995; 163: 458-71.
Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, Lawthers AG, Newhouse JP, Weiler PC, Hiatt HH. Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice study I. N Engl J Med 1991; 324:370-6.
Brennan TA, Hebert LE, Laird NM, Lawthers A, Thorpe KE, Leape LL, Localio AR, Lipsitz SR, Newhouse JP, Weiler PC et al. Hospital characteristics associated with adverse events and substandard care JAMA. 1991; 265: 3265-9.
Queneau P, Chabot JM, Rajaona H, Boissier C, Grandmottet P. Iatrogenic disease observed in a hospital setting. II. Analysis of causes and suggestions for novel preventive measures. Bull Acad Natl Med 1992; 176: 651-64.
Leape LL, Brennan TA, Laird N, Lawthers AG, Localio AR, Barnes BA, Hebert L, Newhouse JP, Weiler PC, Hiatt H. The nature of adverse events in hospitalized patients.Results of yhe Harvard Medical Practice study II. N Engl J Med 1991; 324: 377-84.
Hugues FC, Le Jeune C, Boutot F, Lowenstein W, Haas C. Evaluation of pathology of drug origin in a department of internal medicine. Ann Med Interne 1986; 137: 41-5.
Roblot P, de Bayser L, Barrier J, Marechaud R, Becq-Giraudon B. Primum non nocere. Prospective study of 115 cases of iatrogenic diseases collected over one year in 106 patients. Rev Med Interne 1994; 15: 720-6.
Caranasos GJ, Stewart RB, Cluff LE. Drug-induced illness leading to hospitalization. JAMA 1974; 228: 713-7.
Burnun JF. Preventability of adverse drug reactions. Ann Intern Med 1976; 85: 80-1.
Burstin HR, Lipsitz SR, Brennan TA. Socioeconomic status and the risk for substandard medical care. JAMA 1992; 268: 2383-7.