Selected medical errors in the intensive care unit: results of the IATROREF study: parts I and II. - Archive ouverte HAL Access content directly
Journal Articles American Journal of Respiratory and Critical Care Medicine Year : 2010

Selected medical errors in the intensive care unit: results of the IATROREF study: parts I and II.

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Abstract

RATIONALE: Although intensive care units (ICUs) were created for patients with life-threatening illnesses, the ICU environment generates a high risk of iatrogenic events. Identifying medical errors (MEs) that serve as indicators for iatrogenic risk is crucial for purposes of reporting and prevention. OBJECTIVES: We describe the selection of indicator MEs, the incidence of such MEs, and their relationship with mortality. METHODS: We selected indicator MEs using Delphi techniques. An observational prospective multicenter cohort study of these MEs was conducted from March 27 to April 3, 2006, in 70 ICUs; 16 (23%) centers were audited. Harm from MEs was collected using specific scales. MEASUREMENTS AND MAIN RESULTS: Fourteen types of MEs were selected as indicators; 1,192 MEs were reported for 1,369 patients, and 367 (26.8%) patients experienced at least 1 ME (2.1/1,000 patient-days). The most common MEs were insulin administration errors (185.9/1,000 d of insulin treatment). Of the 1,192 medical errors, 183 (15.4%) in 128 (9.3%) patients were adverse events that were followed by one or more clinical consequences (n = 163) or that required one or more procedures or treatments (n = 58). By multivariable analysis, having two or more adverse events was an independent risk factor for ICU mortality (odds ratio, 3.09; 95% confidence interval, 1.30-7.36; P = 0.039). CONCLUSIONS: The impact of medical errors on mortality indicates an urgent need to develop prevention programs. We have planned a study to assess a program based on our results.
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inserm-00452785 , version 1 (03-02-2010)

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Maïté Garrouste-Orgeas, Jean-François Timsit, Aurelien Vesin, Carole Schwebel, Patrick Arnodo, et al.. Selected medical errors in the intensive care unit: results of the IATROREF study: parts I and II.. American Journal of Respiratory and Critical Care Medicine, 2010, 181 (2), pp.134-42. ⟨10.1164/rccm.200812-1820OC⟩. ⟨inserm-00452785⟩
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