Preventable adverse drug events in hospitalized patients: A comparative study of intensive care and general care units

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Abstract

Objectives

To compare the frequency and preventability of adverse drug events and potential adverse drug events in intensive care units (ICUs) and non-ICUs. To evaluate systems factors involving the individual caregivers, care unit teams, and patients involved in each adverse drug event by comparing ICUs with non-ICUs and medical ICUs with surgical ICUs.

Design

Prospective cohort study. Participants included all 4,031 adult admissions to a stratified, random sample of 11 medical and surgical units in two tertiary care hospitals over a 6-month period. Units included two medical and three surgical ICUs and four medical and two surgical general care units.

Setting

Two tertiary care hospitals: Eleven medical and surgical units, including two medical and three surgical ICUs.

Patients

Adult admissions (n = 4,031).

Interventions

None.

Measurements and Main Results

Rate of preventable adverse drug events and potential adverse drug events, length of stay, charges, costs, and measures of the unit's environment.

Conclusions

The rate of preventable and potential adverse drug events was twice as high in ICUs compared with non-ICUs. However, when adjusted for the number of drugs ordered, there was no greater likelihood for preventable adverse drug events and potential adverse drug events to occur in ICUs than in non-ICUs. Preventable adverse drug events and potential adverse drug events occurred in units that functioned normally and involved caregivers who were working under reasonably normal circumstances, not at the extremes of workload, stress, or a difficult environment. (Crit Care Med 1997; 25:1289-1297)

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