Intensive care unit safety incidents for medical versus surgical patients: a prospective multicenter study.
OBJECTIVE
The aim of this study is to determine if patient safety incidents and the system-related factors contributing to them systematically differ for medical versus surgical patients in intensive care units.


METHODS
We conducted a multicenter prospective study of 646 incidents involving adult medical patients and 707 incidents involving adult surgical patients that were reported to an anonymous patient safety registry over a 2-year period. We compared incident characteristics, patient harm, and associated system factors for medical versus surgical patients.


RESULTS
The proportion of safety incidents reported for medical versus surgical patients differed for only 3 of 11 categories: equipment/devices (14% vs 19%; P = .02), "line, tube, or drain" events (8% vs 13%; P = .001), and computerized physician order entry (13% vs 6%; P < or = .001). The type of patient harm associated with incidents also did not differ. System factors were similar for medical versus surgical patients, with training and teamwork being the most important factors in both groups.


CONCLUSIONS
Medical and surgical patients in the intensive care unit experience very similar types of safety incidents with similar associated patient harm and system factors. Common initiatives to improve patient safety for medical and surgical patients should be undertaken with a specific focus on improving training and teamwork among the intensive care team.
Sinopoli
David J
DJ
UMDNJ-Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA.
Needham
Dale M
DM
Thompson
David A
DA
Holzmueller
Christine G
CG
Dorman
Todd
T
Lubomski
Lisa H
LH
Wu
Albert W
AW
Morlock
Laura L
LL
Makary
Martin A
MA
Pronovost
Peter J
PJ
D000328:Adult; D000368:Aged; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology / Q000517:prevention & control; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D019300:Medical Errors / Q000517:prevention & control* / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D011182:Postoperative Care; D011446:Prospective Studies; D012308:Risk Management / Q000706:statistics & numerical data*; D018571:Sentinel Surveillance; D014481:United States / Q000453:epidemiology