Assessment of patient safety management system in ICU

Complexity of clinical situation، non-oriented patients and abundant medical devices make the ICUs one of the most prevalent wards for patient harms and incidents.

The purpose of this study was to assess patient safety management system in ICU for hospitals of Shahid Beheshti University of Medical Sciences.

This descriptive study was carried out in 9 hospitals of Shahid Beheshti University of Medical Sciences which had Intensive Care Unit in 2011. Structural survey of patient safety assessment was used to identify status quo of hospitals. The sample size was 54 employees، top and middle managers، patients and their relatives who were interviewed. The Failure Mode and Effects Analysis (FMEA) method was used for specific identification of ICU in terms of patients safety by group discussion in clinical teams and the VOLERE logics was used to design patient safety management system based on identifying functional and nonfunctional requirements.

Mean scores of 6 main components of the questionnaire (safety culture، safety leadership، patient and family partnership on safety، reporting safety errors and incidents، safety education and technology/environment) were lower than expected. Some failures identified by FMEA were: admission and discharge error، medication error، patient fall and high rate of infection. With regards to the Risk Priority Number (RPN)، the highest score was related to nosocomial infection and the and lowest score was related to re-extubation because of inability to open the patient airway. Familiarity and responsibility of the clinical teams، managers and hospital staff about patient safety were low and organizational and managerial problems were the root causes of many failures and errors in the ICUs.

With regards to the results، designing a patient safety management system is strongly needed and the proposed system of this study can be applied in other intensive care units.