Chest
Clinical Investigations in Critical CareFactors Associated With Reintubation in Intensive Care: An Analysis of Causes and Outcomes
Section snippets
Materials and Methods
Following medical and nursing collaboration, the AIMS-ICU study was established in 1993 to provide an anonymous, voluntary incident reporting system for ICUs throughout Australia and New Zealand. The initial development and methodology of this project have been described previously.1920 More than 90 ICUs were registered with the project at the time of this review.
An incident was defined as any unintended event or outcome that could have, or did, reduce the safety margin for the patient. It may
Results
Since 1993, 93 units had progressively enrolled in the AIMS-ICU study. By December 1999, these units had contributed 7,525 reports describing > 11,000 incidents. These incidents fall into five major categories: (1) airway and ventilation (n = 1,829), (2) drugs and therapeutics (n = 2,744), (3) procedures, lines, and equipment (n = 2,687), (4) patient management and environment (n = 2,267), and (5) unit management (n = 1,572). Reintubation incidents are included in the first category; 241
Discussion
Quality has become a major issue in health-care provision by both nursing and medical staff in the intensive-care environment. The need for measurement of quality based on patient outcomes and complications remains a complex problem. Incident reporting is well established in Australia and New Zealand ICUs through the AIMS-ICU study. This study provides reporting of incidents, which permit the identification of active and latent errors. The reporters of incidents are health professionals
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