Incidence and risk factors for incidents in intensive care patients

Keywords: Adult Health; Patient Safety; Intensive Care Units; Critical Care Nursing.

Abstract

Objective: to estimate the incidence and identify the risk factors for incidents in patients of an intensive care center. Methods: this is a longitudinal, prospective, analytical, and exploratory study with 173 patients admitted to the intensive care unit. The incidents were categorized as clinical process/procedure, care associated infections, behavior, documentation, medication/intravenous fluids, nutrition, blood products, accidents, and medical equipment. Results: the incidence density was 134.45 incidents per 1,000 patient-days, highlighting the main categories: clinical process/procedure (71.5%) and care-related infections (15.3%). Length of stay in the intensive care unit (Risk ratio: 1.03; Confidence interval: 1.01-1.05; p=0.000) and use of central venous catheter (Risk ratio 1.02; Confidence interval: 1.00-1.04; p=0.040) were identified as risk factors. Conclusion: there was a high occurrence of incidents in the intensive care unit, especially in patients with longer hospital stay and use of central venous catheters. Contributions to practice: identifying incidents and associated risk factors will allow managers and professionals to recognize patients at higher risk and implement measures to ensure systematic and quality care to minimize the occurrence of adverse events in the institution.


References

Siqueira VRB, Carvalho Vasconcelos WPC, Santos GM, Oliveira GKS. Contribuições da tecnologia para assistência de enfermagem da Unidade de Terapia Intensiva. Sustinere. 2019;7(1):19-31. doi: https://doi.org/10.12957/sustinere.2019.40086

Galazzi A, Adamini I, Consonni D, Roselli P, Rancati D, Ghilardi G, et al. Accidental removal of devices in intensive care unit: an eight-year observational study. Intensive Crit Care Nurs. 2019;54:34-8. doi: https://doi.org/10.1016/j.iccn.2019.06.002

Bica T, Wegner W, Gerhardt L, Predebon C, Pedro E, Breigeiron M. Characteristics of patient safety incidents notified in a pediatric intensive care unit. Rev Enferm UFPE on line [Internet]. 2017 [cited Jan. 13, 2022];11(supl.10):4206-16. Available from:https://periodicos.ufpe.br/revistas/revistaenfermagem/article/view/231184/25164

Maia CS, Freitas DRC, Gallo LG, Araújo WN. Registry of adverse events related to health care that results in deaths in Brazil, 2014-2016. Epidemiol Serv Saude. 2018;27(2):e2017320. doi: https://doi.org/10.5123/S1679-49742018000200004

Gadelha GO, Paixão HCS, Prado PR, Viana RAPP, Amaral TLM. Risk factors for death in patients with non-infectious adverse events. Rev Latino-Am Enfermagem. 2018;26:e3001. doi: https://doi.org/10.1590/1518-8345.2069.3001

Souza VS, Derenzo N, Costa MAR, Mendonça RR, Lima WLF, Matsuda LM. Climate of safety in intensive therapy for adults: focus on nursing professionals. Av Enferm. 2019;37(1):83-91. doi: https://doi.org/10.15446/av.enferm.v37n1.72594

Sousa TJ, Oliveira DF, Santos ACG, Conceição LN, Estrela FM, Marinho CS, et al. Prevention measures related to adverse events in the intensive care unit. Saúde Coletiva (Barueri). 2021;11(65):5940-55. doi: https://doi.org/10.36489/saudecoletiva.2021v11i65p5940-5955

Figueiredo ML, D’Innocenzo M. Adverse events related to pratical assistence: an integrative review. Enferm Glob. 2017;16(3):605-50. doi: https://doi.org/10.6018/eglobal.16.3.256091

Araya Farías I, Febré N. Impact of interventions in the pressure ulcer rate. Rev Calid Asist. 2017;32(6):322-7. doi https://doi.org/10.1016/j.cali.2017.10.003

Figueiredo ML, Oliveira e Silva CS, Brito MFSF, D’Innocenz M. Analysis of incidents notified in a general hospital. Rev Bras Enferm. 2018;71(1):111-9. doi: https://dx.doi.org/10.1590/0034-7167-2016-0574

Zanetti ACB, Dias BM, Bernardes A, Capucho HC, Balsanelli AP, Moura AAD, et al. Incidence and preventability of adverse events in adult patients admitted to a Brazilian teaching hospital. PLoS One. 2021;16(4):e0249531. doi: https://dx.doi.org/10.1371/journal.pone.0249531

Aikawa G, Ouchi A, Sakuramoto H, Ono C, Hatozaki C, Okamoto M, et al. Impact of adverse events on patient outcomes in a Japanese intensive care unit: a retrospective observational study. Nurs Open. 2021;8(6):3271-3280. doi: http://dx.doi.org/10.1002/nop2.1040

Mascarello A, Massaroli A, Pitilin EB, Araújo JS, Rodrigues ME, Souza JB. Incidents and adverse events notified at hospital level. Rev Rene. 2021;22:e60001. doi: https://dx.doi.org/10.15253/2175-6783.20212260001

Ortega DB, D’Innocenzo M, Silva LMG, Bohomol E. Analysis of adverse events in patients admitted to an intensive care unit. Acta Paul Enferm. 2017;30(2):168-73. doi: https://dx.doi.org/10.1590/1982-0194201700026

Toffoletto MC, Oliveira EM, Andolhe R, Barbosa RL, Padilha KG. Comparison between patient severity and nursing workload before and after the occurrence of adverse events in elderly in critical care. Texto Contexto Enferm. 2018;27(1):e3780016. doi: http://doi.org/10.1590/0104-070720180003780016

Barcelos RA, Tavares DMS. Factors associated with patient safety incidents among elderly people in intensive care. Acta Paul Enferm. 2017;30(2):159-67. doi: https://dx.doi.org/10.1590/1982-0194201700025

Melo M, Oliveira C, Rodrigues I, Souza C, Sousa C, Mendonça S, et al. Eventos adversos relacionados ao cateter venoso central em pacientes internados em um hospital de ensino. Rev Enferm Atual In Derme. 2020;93(31):e-20049.doi: https://doi.org/10.31011/reaid-2020-v.93-n.31-art.747

Bell T, O’Grady NP. Prevention of central line-associated bloodstream infections. Infect Dis Clin North Am. 2017;31(3):551-59. doi: https://doi.org/10.1016/j.idc.2017.05.007

Published
2022-06-03
How to Cite
Campos, D. M. de P., Toledo, L. V., Matos, S. S. de, Alcoforado, C. L. G. C., & Ercole, F. F. (2022). Incidence and risk factors for incidents in intensive care patients. Rev Rene, 23, e72426. https://doi.org/10.15253/2175-6783.20222372426
Section
Research Article