Intensive Care Unit Risk Assessment: A Systematic Review.

Area of Science:

• Healthcare quality improvement
• Patient safety research
• Clinical risk management

Background:

• Reducing clinical risks is vital for enhancing healthcare quality, patient satisfaction, and minimizing medical errors.
• Hospital intensive care units (ICUs) present unique challenges for patient safety.
• This study focuses on identifying unacceptable risks within hospital ICUs.

Purpose of the Study:

• To detect potential and unacceptable risks in hospital intensive care units (ICUs).
• To systematically review studies utilizing Failure Mode and Effect Analysis (FMEA) for ICU risk assessment.

Main Methods:

• Systematic review of studies on ICU risk assessment using Failure Mode and Effect Analysis (FMEA).
• Comprehensive literature search across major databases (Google Scholar, PubMed, Scopus, etc.) from 1980 to 2019.

Main Results:

• Frequent failures include high infection risks from medical/nursing operations and device usage, and early patient discharge.
• Key processes with high-risk failures: injection/prescription, suction, endotracheal tube management, patient transfer, pressure ulcers, and medical device operations.
• Identified failures often lead to serious patient harm and are difficult for personnel to detect.

Conclusions:

• Numerous factors contribute to failures in critical ICU processes.
• Failure modes in these processes pose significant risks of severe patient harm.
• Low detection probability of failures highlights the need for proactive risk management strategies.