Critical Care Patients at Risk for Medical Errors

By Christina Orlovsky, senior staff writer Critical care patients are among the sickest in any hospital. A new study has found that they may also be among those at greatest risk of medical errors and life-threatening adverse events. According to The Critical Care Safety Study, sponsored by the Health and Human Services Agency for Healthcare Research and Quality (AHRQ), patients in intensive care units are vulnerable to errors in care and susceptible to infection. The study was published in the August issue of the journal Critical Care Medicine. The small study, led by researchers at Harvard University Medical School, in Boston, Massachusetts, observed patients in two intensive care units at an academic hospitala medical intensive care unit and a coronary intensive care unitover a year between July 2002 and June 2003. Results showed that more than 20 percent of 391 patients admitted to the ICUs experienced an adverse eventalmost half of which, or 45 percent, were preventable. The number of adverse events totaled 120 in 79 patients. Thirteen percent were life-threatening or fatal. The total number of serious medical errors reported was 223, of which 11 percent were potentially life-threatening. The study also concluded that the most common error involved giving patients the wrong dose of medication. In fact, 61 percent of the serious medical errors occurred during the ordering or executions of treatments and medications. More than 90 percent of all incidents occurred during routine care, rather than on admission or during an emergency procedure, according to the AHRQ. Both the AHRQ and the studys lead author expressed that these findings are crucial calls to action for all critical care providers. Even though its a small study, it demonstrates the potential for harm in our critical care units in a dramatic way, said Carolyn M. Clancy, M.D., director of the Agency for Healthcare Research and Quality. Study author Jeffrey Rothschild, M.D., M.P.H., an instructor of medicine at Harvard Medical School and an associate physician at Brigham and Womens Hospital, in Boston, Massachusetts, added that the studys results should serve as an impetus for increased safety measures among all health care workers, especially those treating critical care patients. During our lifetimes, we can expect to be admitted to an ICU at least once, Rothschild said. We hope these findings will stimulate the adoption of known interventions, like ensuring hand washing, better physician/nurse communication and greater use of health IT. Rhonda Hughes, Ph.D., RN, senior health analyst with AHRQ, added that the key to improving patient safety in all units is taking an extra second to really focus on what's being done. In the ICU, where there's a lot of activity, it's essential to eliminate distractions. A lot of errors can be decreased if we understand what's going on and constantly support each other to do what's right, Hughes said. Just taking a few seconds to do that can really save a patient's life. For more information or the full study, visit the Critical Care Medicine or AHRQ Web sites. 2005. AMN Healthcare, Inc. All Rights Reserved.

Submitted By: Rachel V. Sorilla NR42