Impact of adverse events on patient outcomes in a Japanese intensive care unit: a retrospective observational study

Abstract

Adverse events (AEs) are defined as "unintended physical injury resulting from or contributed to by medical care that requires additional monitoring, treatment or hospitalization or that results in death (Griffin & Resar, 2009)." Diverse studies from various countries reported that AEs developed in 12% of hospitalized patients (Panagioti et al., 2019) while the severe and unstable patients often seen in the intensive care unit (ICU) experienced more AEs than those in other general wards (Andrews et al., 1997). Up to 20%-25% of ICU patients experience an adverse event (AE), with 45.3-80.5 events per 1000 patient-days, and, within these events, 13% were lethal or life-threatening (Rothschild et al., 2005;Sauro et al., 2020).Numerous international studies show that AEs increase ICU stay length by 8.9 days and the length of a hospital stay by 6.8 days (Ahmed et al., 2015).The incidence of AEs varies according to national background and medical culture. For example, anaesthesia-related mortality is higher in developing countries than in developed countries (Bainbridge et al., 2012). Also, patient safety culture scores have been found to be negatively correlated with AEs incidence (Han et al., 2020;

Impact of Collaborative Nursing Care Delivery on Patient Safety Events in an Emergency Intensive Care Unit: A Retrospective Observational Study

“…Multiple risk factors for PSEs have been reported, most notably in relation to delirium and prolonged hospital stay. 5,18,27,39 Although the postintervention had a high rate of mechanical ventilation, which has been identified as a risk factor for PSEs in several previous studies, 5,18,31,53 the current study found a low incidence of PSEs. Therefore, the collaborative 4:2 NCDS could possibly be effective even in a population at high risk for developing PSEs.…”

“…We determined the relationship between PSEs and length of stay and calculated the number of days spent in the EICU by examining the date of EICU admission and discharge. 5,18,31 Because staffing and bed occupancy rate (BOR) are also factors associated with PSEs, we investigated the number of nurses per shift, the number of patients admitted, and the number of available beds. 10,32 During the day shift (8:00-16:00), many nurses attend training and meetings, and it is difficult to assess how many nurses are involved in patient care retrospectively.…”

“…The line/tube/drain events (LTD events) were defined as events in which an implanted line, tube, or drain was removed or disconnected by the patient. 5,9,14,17,25,27,[33][34][35][36][37] The fall events were defined as events in which a patient falls from their bed or wheelchair on their own. 4,5,18,24,31,38 The LTD and Fall events were determined from incident reports.…”

“…5,9,14,17,25,27,[33][34][35][36][37] The fall events were defined as events in which a patient falls from their bed or wheelchair on their own. 4,5,18,24,31,38 The LTD and Fall events were determined from incident reports. The LTD events and Fall events were defined as "PSEs" regardless of their type or number of occurrences, and the number of PSEs per 1000 patient-days was calculated using the following formula: ([Number of PSEs / Total number of hospital days] Â 1000).…”

“…4 One study in Japan also found a relationship between PSEs and ICU length of stay. 5 In addition, PSEs can inflict distress upon patients and healthcare workers, with nearly 30% of affected individuals exhibiting eating and sleep disorders. 3,6,7 Patient safety events also create substantial economic burden, with estimates showing costs of up to U.S. $ 3244 8 and U.S. $ 181 per event if the patient is responsible for device removal, 9 thereby leading to significant economic consequences.…”