Methods of Adverse Event Detection in Intensive Care: A Systematic Review.

Area of Science:

• Critical Care Medicine
• Patient Safety Research
• Healthcare Quality Improvement

Background:

• Adverse events in Intensive Care Units (ICUs) pose significant risks to patient safety.
• Effective detection methods are essential for identifying and mitigating these events.
• Current methods vary across neonatal, pediatric, and adult ICU settings.

Purpose of the Study:

• To systematically review and characterize adverse event detection methods used in ICUs.
• To summarize the performance characteristics of different detection strategies.
• To inform patient safety initiatives through evidence-based insights.

Main Methods:

• Systematic literature search across multiple databases (Ovid MEDLINE, Embase, CINAHL, Cochrane Library, Google Scholar).
• Independent screening and full-text review of articles by two reviewers.
• Inclusion of original research on adverse event detection methods in peer-reviewed journals.

Main Results:

• Fifty-nine studies in neonatal, pediatric, and adult ICUs were analyzed.
• Incident reporting (IR), trigger tool use, trained observation (TO), and structured review were common methods.
• Trained observation identified the most adverse events (57.3 per 100 patient days), while IR identified the least (6.4).
• Only 20% of studies reported quality improvement initiatives.

Conclusions:

• Combining multiple adverse event detection methods is recommended for comprehensive results.
• Standardization of adverse event definitions and harm levels is needed for better comparison.
• Increased emphasis on disseminating practice changes following detection is vital for patient safety.