Evaluation of two methods for quality improvement in intensive care: Facilitated incident monitoring and retrospective medical chart review*

Beckmann, Ursula; Bohringer, Christian H; Carless, Ruth; Gillies, Donna; Runciman, William B.; Wu, Albert W.; Pronovost, Peter J.

doi:10.1097/01.ccm.0000060016.21525.3c

Cited by 141 publications

(85 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…While these advances are generally regarded as positive, this progress has introduced many invasive procedures that have the potential of causing harm to the patient. Moreover, the involvement of various physicians and nurses in patients' care in an intensive care unit necessitates effective communication between the different specialties [1,4,17]. The intensivist has an important coordinating role in this environment [2].…”

Section: Introductionmentioning

confidence: 99%

Critical incidents in paediatric critical care: who is at risk?

2010

View full text Add to dashboard Cite

We evaluated the characteristics of children for whom critical incidents (CIs) were reported by performing prospective collection of patient data and retrospective review of reported CIs in a multidisciplinary neonatal-paediatric intensive care unit of a tertiary care university children's hospital. A period of 1 year was analysed (January to December 2007; 1,251 admissions). CIs comprised adverse events (actual patient injury), as well as near-misses. The report form of critical incidents was web-based and reporting was voluntary, anonymous and non-punitive. The severity of all CIs was divided into minor, moderate and major. Patients with and without CIs were compared regarding the following characteristics: Paediatric Index of Mortality (PIM2), duration of mechanical ventilation, length of stay in the intensive care, admission mode (surgery, cardiopulmonary bypass, cardiac/non-cardiac unit), age and sex. There were 360 CI reports (83 per 1,000 patient days; 13% major, 26% moderate, 61% minor severity). Of these, 310 CIs could be assigned to 198 specific patients. In the univariate analysis, patient-related risk factors for CIs were higher PIM2 score (p < 0.0001), increased length of stay (p < 0.0001), mechanical ventilation (p < 0.0001), increased ventilator days (p < 0.0001), male gender (p = 0.022) and young age (p < 0.0001). Using a logistic regression model, mechanical ventilation (p < 0.0001), male gender (p = 0.034) and length of stay (p < 0.0001) continued to be associated with the occurrence of CIs. Conclusion CIs often occur in paediatric intensive care. Among the patient-related factors, male gender, mechanical ventilation, and length of stay are independently associated with CIs. Already known at admission to intensive care are male gender and, usually, requirement for mechanical ventilation. Improved knowledge of the risk factors for CIs could help to minimize their frequency and thus improve quality of care.

show abstract

Section: Introductionmentioning

confidence: 99%

Critical incidents in paediatric critical care: who is at risk?

2010

View full text Add to dashboard Cite

show abstract

“…Zur Erfassung von Fehlern an Intensivstationen sind verschiedene Methoden beschrieben worden, keine davon wird jedoch in der Lage sein, die absolute Fehlerhäufigkeit zu erfassen und die Ergebnisse werden je nach Methode unterschiedlich sein [4].…”

Section: Das Wahrnehmen Von Fehlernunclassified

Fehlerentstehung und Fehlerprävention auf Intensivstationen

Valentin

2012

Med Klin Intensivmed Notfmed

View full text Add to dashboard Cite

“…Audits of medical records are commonly used in quality improvement initiatives to assess hospital performance and effect change [8][9][10] . The medical record provides insight into specific components of patient care including physician and nursing care, ancillary support services, and if polices and procedures are being followed.…”

Section: Introductionmentioning

confidence: 99%