Reference | Type of ICUs | Method of study | Description of method | Definition of ADE | ADEs/1000 patient-days |
5 | MICU, SICU | Trigger tool | ADEs were identified by extraction from the ADE programme database, retrospective screening of ICD codes and reviewing antidote use and potentially drug-related electrolyte disturbances | Injury resulting from drug treatment | 2.4 |
6 | Not specified | Trigger tool | Charts were chosen randomly, and IHI trigger tool was applied using predesigned data collection forms. Charts were reviewed for 20 min, and if a trigger was detected only the portion of the chart relevant to it was reviewed. Severity of the adverse events was classified. | Medication related adverse event | 20 |
7 | SICU | Prescription review | The ICU pharmacist analysed every medication order of randomly selected patients during study period. | Medication prescribing errors that cause harm to patient | 87.5 |
1 | 2 MICU, 3 SICU | Multifaceted | Nurses and pharmacists were asked to report incidents using logs. A trained nurse visited each unit at least twice daily on weekdays and solicited information from staff concerning all actual or potential drug related incidents. A study nurse briefly reviewed all charts at least daily on weekdays. | A preventable injury resulting from medical intervention related to a drug | 5.1 |
8 | 2 CSICU, 2 CS stepdown unit | Multifaceted | Pump-related transaction data were obtained from smart pump log downloads. Log reports included pump alerts. In addition, error reports were collected by chart review, solicited staff reports, hospital incident reports and a computerised ADE surveillance monitor. | Injury due to a medication | 6.1 |
9 | 2 MICU, 3 SICU | Multifaceted | Nurses and pharmacists were asked to report incidents using logs. A trained nurse visited each unit at least twice daily on weekdays and solicited information from staff concerning all actual or potential drug related incidents. A study nurse briefly reviewed all charts at least daily on weekdays. | Injury resulting from medical intervention related to a drug | 14.4 |
10 | MICU, CCU | Multifaceted | Two investigators identified incidents by review of medical records in which they examined all progress notes, orders and lab results. Pharmacist interventions were also tracked on a form. | Injury related to use of a medication | 29.8 |
11 | CCU | Multifaceted | Nurses and pharmacists were asked to report incidents using logs. A trained nurse visited each unit at least twice daily on weekdays and solicited information from staff concerning all actual or potential drug related incidents. A study nurse briefly reviewed all charts at least daily on weekdays. | An injury resulting from the administration of a drug | 33 |
12 | MICU, CCU | Multifaceted | Primary method of data collection was direct continuous observation. Voluntary and solicited reports were also used to identify incidents. Computerised ADE detection was also used to monitor events. Also, guided chart abstraction by trained research nurses was performed. | Any injury due to medical management, rather than the underlying disease | 37.6 |
PADE definition | PADEs/1000 patient-days | ||||
1 | 2 MICU, 3 SICU | Multifaceted | Nurses and pharmacists were asked to report incidents using logs, a trained nurse visited each unit at least twice daily on weekdays and solicited information from staff concerning all actual or potential drug related incidents, and a study nurse briefly reviewed all charts at least daily on weekdays. | Incident with a potential for injury related to a drug | 13.5 |
8 | 2 CSICU, 2 cardiac surgery stepdown unit | Multifaceted | Pump-related transaction data were obtained from smart pump log downloads. Log reports included pump alerts. In addition, error reports were collected by chart review, solicited staff reports, hospital incident reports and a computerised ADE surveillance monitor | ME that had the potential to cause harm but did not because it either was intercepted before reaching the patient or reached the patient and because of luck did not cause harm | 23.8 |
13 | Surgical/trauma ICU | Trigger tool | All patients admitted during a 3-month period were monitored for abnormalities in their potassium, magnesium, liver enzymes, blood glucose, serum creatinine and platelet count. Once identified, they were categorised as possibly, probably or definitely caused by a drug used in the patient. They were also classified in terms of severity on a scale from no change in outcome to death. | Drug-related hazardous condition: a biochemical response to a drug that has the potential to cause clinical injury | 47 DRHCs/ 1000 patient-days |
Definition of ADE | ADEs/100 orders | ||||
14 | Mixed PICU | Observation of entire medication process | One nurse was picked randomly at the start of each shift and followed to observe prescriptions from writing to administration | Not provided | 3.6 |
15 | Mixed ICU | Observation of entire medication process | Two pharmacy residents recorded activities related to medication use process using standardised data collection sheets. The observers followed the entire medication process from prescription writing to administration. | An injury or patient harm occurring as the result of a medication intervention; can be preventable or non-preventable | 4.3 |
CCU, critical care unit; CSICU, cardiac surgery intensive-care unit; ICU, intensive care unit; ME, medication error; MICU, medical intensive care unit; PICU, paediatric intensive care unit; SICU, surgical intensive care unit.