Intensive Care Unit Risk Assessment: A Systematic Review

Homauni, Abbas; Jame, Sanaz Zargar Balaye; Hazrati, Ebrahim; Markazi-Moghaddam, Nader

doi:10.18502/ijph.v49i8.3865

Cited by 9 publications

(5 citation statements)

References 26 publications

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“…In the case of the volumetric ventilator, the highest priority causes are related to the operator's handling of equipment components, particularly the filter and the power cable. When complementing the Ishikawa diagram analysis, a situation similar to the one presented In general, the found results contrast with those of other studies that used the FMEA method in the ICU, where the failures with the highest priority related to alarms of the ventilation device 17 or increased rates of internal infection due to the inadequate operation of the medical equipment 18 are reported. It is important to note that the FMEA method's application in each case depends on the quantity and quality of the information collected and that the value of the results will be maintained in direct relation to its updating.…”

Section: Discussioncontrasting

confidence: 56%

A risk assessment method based on the failure analysis of medical devices in the adult Intensive Care Unit

Licona¹,

Perez-Ramos²

2021

GlobalCE

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Backgrounds and Objective: The Intensive Care Unit (ICU) receives patients whose situation demands high complexity tasks. Their recovery depends on medical care, their response to medications and clinical procedures, and the optimal functioning of the medical devices devoted to them. Adverse events in ICU due to failures in the facilities, particularly medical devices, have an important impact not only on the patients but also on the operators and all those involved in their care. The origins of the technological failures seem to be more oriented to the interaction between the equipment and the operator: once the medical equipment is functioning, we must guarantee its correct execution to meet both the clinical service's objectives and the expectations of those involved in care, including the patients themselves. We present an approach to quality management based on failure analysis as the source of risk for medical devices' functioning and operation in the ICU. We decided to address it through a systematic approach by using the Failure Mode and Effects Analysis (FMEA) method and the Ishikawa diagrams' support to obtain the causes graphically. Material and Methods: We used the risk analysis framework as a basis of the methodology. By obtaining the causes and sub causes of technological failures in the ICU for adult patients, we applied the FMEA method and the Ishikawa diagrams to analyze the relationship between cause and failure. The ICU devices came from the Official Mexican Standard and WHO information related to the ICU operation and facilities. The data from the causes of failure came from specialized consultation and discussion forums on medical devices where these topics were addressed; we searched for over five years in Spanish forums. We proposed a calculation of the Risk Priority Number based on the information subtracted from the forums. Then, we defined an indicator showing the priority level that can be used to address the issue. Results: In general, the results showed that most of the medical equipment failure causes have medium and high-risk priority levels and, in some cases, the cause presented as the most prevalent didn't match with the reported in official documents such as technical or operation manuals. The most frequent causes found are related to electrical system issues and operation skills. We presented three study cases: defibrillator, vital sign monitor, and volumetric ventilator, to show the risk level designation. The conclusions inferred from these cases are oriented to training strategies and the development of support material in Spanish. Conclusion: The development of risk management methodologies that aim to monitor and solve potential hazard situations in critical areas is valuable to the health technology management program. The FMEA method showed to be a strong basis for the risk assessment processes, and its application to the ICU medical technology allowed the creation of the evidence supporting the decision-making process concerning strategic solutions to guarantee patient safety

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Section: Discussioncontrasting

confidence: 56%

A risk assessment method based on the failure analysis of medical devices in the adult Intensive Care Unit

Licona¹,

Perez-Ramos²

2021

GlobalCE

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“…The outcome of the study was mortality during ICU stay. The predictors were primarily selected based on a consensus of the authors considering the limits of time, budget, and personnel [ 15 , 16 ]. We recorded patients’ sex and age, significant comorbidities, vital signs, information on nosocomial infections if any, the reason for admission, arterial blood gas, and a number of other laboratory test results, GCS on admission or immediately before EI (for patients undergoing EI), and significant procedures (including EI).…”

Section: Methodsmentioning

confidence: 99%

Association of Glasgow coma scale and endotracheal intubation in predicting mortality among patients admitted to the intensive care unit

Markazi-Moghaddam¹,

Fathi²,

Jame³

et al. 2023

ACC

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Background: We assessed predictors of mortality in the intensive care unit (ICU) and investigated if Glasgow coma scale (GCS) is associated with mortality in patients undergoing endotracheal intubation (EI).Methods: From February 2020, we performed a 1-year study on 2,055 adult patients admitted to the ICU of two teaching hospitals. The outcome was mortality during ICU stay and the predictors were patients’ demographic, clinical, and laboratory features.Results: EI was associated with a decreased risk for mortality compared with similar patients (adjusted odds ratio [AOR], 0.32; P=0.030). This shows that EI had been performed correctly with proper indications. Increasing age (AOR, 1.04; P<0.001) or blood pressure (AOR, 1.01; P<0.001), respiratory problems (AOR, 3.24; P<0.001), nosocomial infection (AOR, 1.64; P=0.014), diabetes (AOR, 5.69; P<0.001), history of myocardial infarction (AOR, 2.52; P<0.001), chronic obstructive pulmonary disease (AOR, 3.93; P<0.001), immunosuppression (AOR, 3.15; P<0.001), and the use of anesthetics/sedatives/hypnotics for reasons other than EI (AOR, 4.60; P<0.001) were directly; and GCS (AOR, 0.84; P<0.001) was inversely related to mortality. In patients with trauma surgeries (AOR, 0.62; P=0.014) or other surgical categories (AOR, 0.61; P=0.024) undergoing EI, GCS had an inverse relation with mortality (accuracy=82.6%, area under the receiver operator characteristic curve=0.81).Conclusions: A variety of features affected the risk for mortality in patients admitted to the ICU. Considering GCS score for EI had the potential of affecting prognosis in subgroups of patients such as those with trauma surgeries or other surgical categories.

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“…Such initiatives improve employee satisfaction, reduce burnout, and enhance staff retention. A content and motivated healthcare workforce is more likely to provide compassionate and efficient patient care, contributing to an overall positive hospital reputation and patient outcomes [ 41 ].…”

Section: Reviewmentioning

confidence: 99%

Exploring the Economic Aspects of Hospitals: A Comprehensive Examination of Relevant Factors

Pradhan,

Waghmare,

Alghabshi

et al. 2024

Cureus

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Financial limitations in the hospital industry have the potential to exacerbate healthcare disparities, impede investments in cutting-edge medical treatments, as well as impair patient outcomes. The interdependent connection between a hospital economy and the general well-being of the community highlights the necessity of careful financial oversight and inventive healthcare policies. Effective collaboration among policymakers, healthcare administrators, and stakeholders is imperative in the development of sustainable economic models that give equal weight to fiscal prudence and optimal patient outcomes. This article aims to underscore the pivotal importance of strategic fund allocation guided by hospital administrators, accentuating several key initiatives capable of revolutionizing healthcare delivery and elevating the institution's stature within the medical community. The other important aspects discussed here are fund allocation in hospitals, the boom of online consultations, and emphasis on the use of sustainable and cost-effective modalities of energy.

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Intensive Care Unit Risk Assessment: A Systematic Review

Cited by 9 publications

References 26 publications

A risk assessment method based on the failure analysis of medical devices in the adult Intensive Care Unit

A risk assessment method based on the failure analysis of medical devices in the adult Intensive Care Unit

Association of Glasgow coma scale and endotracheal intubation in predicting mortality among patients admitted to the intensive care unit

Exploring the Economic Aspects of Hospitals: A Comprehensive Examination of Relevant Factors

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