Adverse events in the intensive care unit: impact on mortality and length of stay in a prospective study

Roque, Keroulay Estebanez; Tonini, Teresa; Melo, Enirtes Caetano Prates

doi:10.1590/0102-311x00081815

Cited by 67 publications

(89 citation statements)

References 40 publications

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“…A study assessing AE in an ICU also showed a predominance of older patients, (10) although other studies showed different results with a median age under 65 years. (3,7) Other studies found higher age mean and longer hospital stays for the patients who had an AE, compared to those who did not. (11) Most patients admitted came from Emergency Care for clinical reasons, which is in agreement with other studies, (11) pointing out the importance of having units prepared for the admission of serious patients in hospitals.…”

Section: Discussionmentioning

confidence: 98%

“…Therefore, the outcomes of AE may lead to increased mortality and longer hospital stays. (3) Strategies to evaluate and monitor patients have been adopted in order to assure the quality of care and even reduce the incidence of undesirable events. (4) In ICUs different scales are used to measure clinical and prognostic parameters and the demand for care.…”

Section: Introductionmentioning

confidence: 99%

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Análise de eventos adversos em pacientes internados em unidade de terapia intensiva

et al. 2017

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Objective: To assess the incidence of adverse events and associate them with nursing workload, nursing team staffing and the severity of the patients. Method: A quantitave, cross-sectional, prospective study was conducted with 304 consecutive patients admitted to the General Intensive Care Unit of a private hospital between September and December 2013 (four months). Results: There were 39 adverse events, and the most prevalent was pressure sore. Patients who presented an event had a higher mean age, higher prevalence of clinical admissions, longer hospital stay, higher scores in the Acute Physiology and Chronic Health Evaluation (APACHE) II and in the Nursing Activities Score (NAS) and lower score in the Braden scale and in the Glasgow scale. There was no significant difference regarding nursing team staffing. Conclusion: There was a higher incidence of adverse events in patients who presented a profile of greater risk and severity identified by predictive scales. ResumoObjetivo: Avaliar a incidência de eventos adversos e associá-los com a carga de trabalho de enfermagem, o dimensionamento da equipe de enfermagem e o perfil de gravidade do paciente. Métodos: Foi realizado um estudo transversal, prospectivo, com abordagem quantitativa, em 304 pacientes consecutivos internados em Unidade de Terapia Intensiva geral de um hospital privado, admitidos entre setembro e dezembro de 2013 (quatro meses). Resultados: Ocorreram 39 eventos adversos sendo a lesão por pressão a mais prevalente. Os pacientes que apresentaram algum evento tiveram maior média de idade, maior prevalência de internações clínicas, internações mais prolongadas, maior escala Acute Physiology and Chronic Health Evaluation (APACHE) II, maior pontuação do Nursing Activities Score (NAS), menor escore na escala de Braden e menor escala de Glasgow e não tiveram diferenças significantes em relação ao dimensionamento da equipe de enfermagem. Conclusão: Houve maior incidência de eventos adversos em pacientes que exibiram um perfil de maior risco e gravidade identificados por meio de escalas preditoras.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Análise de eventos adversos em pacientes internados em unidade de terapia intensiva

et al. 2017

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“…Research has observed that these same events prolonged hospitalization time, on average, in 19 days, and increased mortality. 16 In another study, this time was even longer, 31 days.…”

mentioning

confidence: 95%

“…15 Another study found a lower value, about 32.4% of the patients suffered some AE. 16 AEs interfere with patient integrity, resulting in increased morbidity, mortality, treatment time and hospital costs. The male young adult male was the most incident profile.…”

mentioning

confidence: 99%

Eventos adversos na unidade de terapia intensiva

Souza¹,

Alencar

Alves

2018

Rev enferm UFPE on line.

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Objective: to characterize the adverse events of an Intensive Care Unit. Method: quantitative, descriptive, retrospective study with patients admitted to the Intensive Care Unit. Data were collected through a questionnaire. The statistical analysis considered absolute and relative frequencies calculated through the MS Excel program and presented in tables and figures. Results: The occurrence of 152 adverse events was verified. The profile of the patients was highlighted as being male, young adults, with an average of 45 years. The main adverse events identified were: medication errors (29.6%), pressure injury (21%), unplanned extubation (17%), healthcare-associated infections (15.13%), 9.90%), among others. Conclusion: the need for continuing education of professionals, is reinforced in order to sensitize them to notify the events, and the capacitation, to reduce the rates of adverse events. Descriptors: Patient Safety; Quality Indicators, Health Care; Intensive Care Units; Critical Care; Nursery; Education, Continuing. RESUMOObjetivo: caracterizar os eventos adversos de uma Unidade de Terapia Intensiva. Método: estudo quantitativo, descritivo, retrospectivo, com pacientes internados na Unidade de Terapia Intensiva. A coleta de dados ocorreu por meio de questionário. A análise estatística considerou frequências absolutas e relativas calculadas por meio do programa MS Excel e apresentadas em tabelas e figuras. Resultados: constatou-se a ocorrência de 152 eventos adversos. O perfil dos pacientes destacou-se por ser do sexo masculino, adultos jovens, com média de 45 anos. Os principais eventos adversos identificados foram: erros de medicação (29,6%), lesão por pressão (21%), extubação não planejada (17%), infecções associadas aos cuidados de saúde (15,13%), perda de sonda (9,90%), entre outros. Conclusão: reforça-se a necessidade de educação permanente dos profissionais, a fim de sensibilizá-los para notificar os eventos, e da capacitação, para reduzir os índices dos eventos adversos. Descritores: Segurança do Paciente; Indicadores de Qualidade em Assistência à Saúde; Unidades de Terapia Intensiva; Cuidados Críticos; Enfermagem; Educação Continuada. RESUMENObjetivo: caracterizar los eventos adversos de una Unidad de Terapia Intensiva. Método: estudio cuantitativo, descriptivo, retrospectivo, con pacientes internados en la Unidad de Terapia Intensiva. La recolección de datos se produjo por medio de un cuestionario. El análisis estadístico consideró frecuencias absolutas y relativas calculadas a través del programa MS Excel y presentadas en tablas y figuras. Resultados: se constató la ocurrencia de 152 eventos adversos. El perfil de los pacientes se destacó por ser del sexo masculino, adultos jóvenes, con promedio de 45 años. Los principales eventos adversos identificados fueron: errores de medicación (29,6%), lesión por presión (21%), extubación no planificada (17%), infecciones asociadas a la atención de salud (15,13%), pérdida de sonda (9,90%), entre otros. Conclusión: se refuerza la necesidad de educación...

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“…The need for ICU admission stems from hemodynamic instabilities that require intensive care, including the monitoring and continuous administration of medications 2 . In this environment, patients have a weakened health status with a risk of death, and integrated care from the entire team is required because these patients are usually unconscious due to ventilatory support or their existing health condition.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with oral biofilm in ICU patients with infectious diseases

Damascena

Rodrigues

Costa

et al. 2017

Rev. odontol. UNESP

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ResumoIntrodução: A hospitalização pode provocar deterioração da saúde bucal, repercutindo em todo o corpo. A UTI pode ser um ambiente favorável ao acúmulo de biofilme oral em pacientes críticos. Objetivo: Identificar fatores associados à presença do biofilme em pacientes da UTI de um hospital de doenças infectocontagiosas. Método: Estudo retrospectivo, descritivo e inferencial, com abordagem quantitativa. Os dados foram obtidos em prontuários de pacientes da UTI, de janeiro de 2012 a julho de 2015. O biofilme foi avaliado de acordo com o índice de Greene e Vermillion. Os fatores influentes foram analisados por regressão logística. Resultado: Entre os pacientes da UTI, 69,1% eram homens, 60,7% pacientes com AIDS, 66,3% pacientes na enfermaria, 50,6% intubados e 50,0% sedados. Seus elementos orais eram na maioria normais. As seguintes características foram significativamente associadas a biofilmes orais: alterações orais nos lábios, gengivas, bochechas e palatos e sangramento. Pacientes da enfermaria apresentaram menor risco de apresentar biofilmes. Conclusão: o aumento do acúmulo de biofilme oral foi observado em pacientes com alterações na boca e a procedência do paciente foi associada à presença de biofilme.Descritores: Hospital; paciente; saúde bucal; manifestações orais; biofilme. AbstractIntroduction: Hospitalization may cause a decline in oral health and affect the entire body. The intensive care unit (ICU) may be a favorable environment for oral biofilm to accumulate in critically ill patients. Objective: To identify factors associated with oral biofilm in ICU patients in a hospital for infectious diseases. Method: This was a retrospective, descriptive and inferential study with a quantitative approach. Data were collected from 178 medical records of patients from January 2012 to July 2015. Biofilm presence was assessed according to the Greene and Vermillion index. Potential influential factors were analyzed by logistic regression. Result: Among ICU patients, 69.1% were men, 60.7% had acquired immune deficiency (AIDS), 66.3% were ward patients, 50.6% were intubated, and 50.0% were sedated. The oral elements of the patients were mostly normal. The following characteristics were significantly associated with oral biofilm: changes in the lips, gums, cheeks, and palates and bleeding. Patients from the ward had a lower risk of biofilm. Conclusion: Increased oral biofilm accumulation was observed in patients with oral changes, and patient origin was associated with the presence of biofilm.

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Adverse events in the intensive care unit: impact on mortality and length of stay in a prospective study

Cited by 67 publications

References 40 publications

Análise de eventos adversos em pacientes internados em unidade de terapia intensiva

Análise de eventos adversos em pacientes internados em unidade de terapia intensiva

Eventos adversos na unidade de terapia intensiva

Factors associated with oral biofilm in ICU patients with infectious diseases

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