Document Detail

Increasing patient safety event reporting in 2 intensive care units: A prospective interventional study.
MedLine Citation:
PMID:  21129913     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: The aims of this study were to increase the reporting of patient safety events and to enhance report analysis and responsive action.
MATERIALS AND METHODS: A prospective, interventional study in 2 adult intensive care units (ICUs) in an academic center was used. A paper-based reporting system, adapted from a previously reported intervention, was introduced. A multifaceted approach, including education, reminders, regular updates, personal and group feedback, and weekly leadership rounds, was led by a patient safety committee. Committee members reviewed the reports and initiated solutions as required.
RESULTS: During the first year, a total of 332 safety events were reported using the new system, reflecting a significant increase in total reporting (10.3/1000 patient days preintervention to 34.5/1000 patient days postintervention; rate ratio, 3.35; 95% confidence interval, 2.23-5.04). Most reports were submitted by nurses (nurses, 75.3%; physicians, 10.5%; other workers, 7.8%). Overall reported events per 1000 patient days differed by unit (level 3 ICU, 44.1; level 2 ICU, 24.9; P < .001). Several system-based interventions were initiated in the ICUs to address reported safety hazards.
CONCLUSIONS: After the introduction of this new approach, reporting rates have increased significantly throughout the first year. Differences in reporting rates among workers and units may reveal priorities and barriers to reporting. The integrated approach facilitated prompt response to selected reports.
Roy Ilan; Mae Squires; Christina Panopoulos; Andrew Day
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Publication Detail:
Type:  Journal Article     Date:  2010-12-03
Journal Detail:
Title:  Journal of critical care     Volume:  26     ISSN:  1557-8615     ISO Abbreviation:  J Crit Care     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  431.e11-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Department of Medicine, Queen's University, Kingston General Hospital, Kingston, ON, Canada K7L 3N6.
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