A study of adverse events in an intensive care unit in Morocco

2014 
Adverse events in an intensive care unit can raise important medical, ethical, legal and economic problems. This study aims at pointing out these adverse events, by assessing their severity, identifying the very risk factors associated with them, and comparing our results with existing evidence-based data. Material and methods: This is a retrospective study in the intensive care unit of the Military Hospital of Instruction Mohammed V, at RABAT, carried out over a period of 3 years and half. Included in the study are medical records of patients with an adverse event (AE) during their hospitalization in the IC (Intensive Care) or elsewhere, and who required a stay in Intensive care. We excluded nosocomial infections and adverse events due to medicated side effects, as there is no conclusive evidence of the accountability of the event to the product. Results: The study focuses on 813 patients. 44 patients experienced at least one adverse event, with an incidence of 5.4%. They were dominated by those of respiratory type (34%), followed by cardiovascular events and neurological disorders. All events were considered as preventable. The identified risk factors were due to human errors in 95% of cases: mainly, careless mistakes. The consequences of adverse events were of varying severity, with a mortality rate of 39% and a residence time of 12 days on average, comparable to those of other patients without iatrogenic complications. Conclusion: In our study, AE are dominated by events of respiratory type, and human error is the main associated factor. The specific impact of these events on prognosis is difficult to assess because they occur in serious situations. The monitoring of AE may constitute a care quality indicator.
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