Artikel
Adverse events in the adult ICU setting, a descriptive study
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Autoren
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Kathrin Thormann
- Department of Dermatology, Inselspital Bern
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Michael Simon
- Nursing research unit, Inselspital Bern
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Franziska Zuniga
- Universität Basel, Institut für Pflegewissenschaft
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Stefanie Bachnick
- Institute of Nursing Science – University of Basel
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Lionel Mueller
- Department of intensive care medicine, Inselspital Bern
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Hans Ulrich Rothen
- Department of intensive care medicine, Inselspital Bern
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Anne Rutjes
- Institute of social and preventive medicine, University of Bern
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Marie-Madlen Jeitziner
- Inselspital, Bern
| Veröffentlicht: | 30. April 2018 |
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Gliederung
Text
Background: Patients in the Intensive Care Unit (ICU) are at high risk for Adverse Events (AEs) and effective AE detection methods are of high value. The IHI Global Trigger Tool (GTT) is a method to detect AEs, but little is known about its use in adult ICUs.
Aims: To assess the prevalence of AEs based on the GTT and to assess the interrater reliability of the GTT methodology
Method: This descriptive study retrospectively assessed the AE detection rate of the GTT, enriched with six self- developed nursing care related triggers. A random sample of 249 electronic patient records were reviewed independently by two nurses and validated by a physician.
Results: A total of 1153 positive triggers and 520 AEs were identified (mean 2.1 AEs per record). The most frequent AEs were healthcare associated infections (42.6%), agitation and physical restraints (each 41.8% of records). 38.7% of the AEs were preventable, all but one was judged to be of temporary nature. Cohens kappa was calculated for 24 (10%) records of the full data collection period. Complete agreement was achieved for the identified AEs.
Conclusion: The proportion of AEs detected by the GTT plus self- developed triggers is high and often deemed preventable. The interrater reliability was excellent. The GTT is useful to identify weaknesses in health care delivered, providing the foundation for targeted interventions to improve patient safety.
Keywords: Global Trigger Tool, Adverse Events, Intensive Care Unit
