Factors associated with post-intensive care unit adverse events: a clinical validation study

Area of Science:

• Critical Care Medicine
• Patient Safety
• Nursing Research

Background:

• Patients discharged from intensive care units (ICU) have complex needs and are at high risk for adverse events in ward settings.
• Limited understanding exists regarding factors contributing to these post-intensive care adverse events.
• A prior study identified 25 potential factors from intensive care liaison nurses' perspectives.

Purpose of the Study:

• To clinically validate the 25 factors identified by nurses as associated with post-intensive care adverse events.
• To assess the relevance and importance of these factors in clinical practice for post-ICU patients.

Main Methods:

• A prospective clinical validation study design was employed.
• Data were collected from a convenience sample of 52 patients across four tertiary hospitals in an Australian capital city.
• All included patients experienced an adverse event following discharge from intensive care.

Main Results:

• All 25 factors were found to contribute to adverse events in at least six patients.
• Patient-specific factors, including illness severity and comorbidities, were most strongly associated with adverse events.
• Non-modifiable factors contribute significantly to the risk of post-ICU adverse events.

Conclusions:

• Clinical care and research should prioritize modifiable factors within care processes to mitigate risks for post-intensive care patients.
• Focusing on modifiable aspects of care can help reduce the incidence of adverse events in the post-ICU population.
• Addressing both modifiable and non-modifiable factors is crucial for improving outcomes in post-intensive care patients.