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

Garrouste-Orgeas, Maite, Timsit, Jean Francois, Vesin, Aurelien, Schwebel, Carole, Arnodo, Patrick, Lefrant, Jean Yves, Souweine, Bertrand, Tabah, Alexis, Charpentier, Julien, Gontiers, Olivier, Fieux, Fabienne, Mourvillier, Bruno, Troche, Gilles, Reignier, Jean, Dumay, Marie Francoise, Azoulay, Elie, Reignier, Bernard, Carlet, Jean and Soufir, Lilia (2010) 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, 181 2: 134-142. doi:10.1164/rccm.200812-1820OC

Author Garrouste-Orgeas, Maite
Timsit, Jean Francois
Vesin, Aurelien
Schwebel, Carole
Arnodo, Patrick
Lefrant, Jean Yves
Souweine, Bertrand
Tabah, Alexis
Charpentier, Julien
Gontiers, Olivier
Fieux, Fabienne
Mourvillier, Bruno
Troche, Gilles
Reignier, Jean
Dumay, Marie Francoise
Azoulay, Elie
Reignier, Bernard
Carlet, Jean
Soufir, Lilia
Title Selected medical errors in the intensive care unit: results of the IATROREF study: parts I and II
Journal name American Journal of Respiratory and Critical Care Medicine   Check publisher's open access policy
ISSN 1073-449X
Publication date 2010-01-15
Sub-type Article (original research)
DOI 10.1164/rccm.200812-1820OC
Open Access Status Not yet assessed
Volume 181
Issue 2
Start page 134
End page 142
Total pages 9
Place of publication New York, NY, United States
Publisher American Thoracic Society
Collection year 2017
Language eng
Formatted 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.
Keyword Adverse event
Intensive care unit
Medical error
Quality indicator
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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