Intensive care unit (ICU) constitutes one of the essential patient care systems at medical centers. Its role is pivotal in sustaining the life of patients and varies with the degree of complexity of patient condition. Over the years, concerns on patient safety are increasing at an alarming rate. Previously, overcoming the problems associated with patient safety was considered a big task. Longo et al. (2005) reported that the process of patient safety system was slow and that there is need for its early improvement in order to meet Institute of Medicine (IOM) recommendations. It is mandatory for a research of any kind to meet the criteria or guidelines set by an authorized committee. I suppose that the above report could draw further attention of many researchers to provide a remedy to this ever-growing problem.
Earlier, it was a challenging task for the health care officials to study the problem of patient safety. Mc Loughlin et al. (2006) worked out a strategy of employing indicators that might lessen the harm to patients. As there is a scope of mutual understanding between the countries, this article would definitely receive wide appreciation and international recognition.
Berenholtz et al. (2007) have described a scorecard method that helps in better monitoring and ameliorating patient safety. This method proves to be reliable in keeping track of outcomes.
Predicting the errors and educating the staff would help inefficient management of patient safety. Regular control would help in immediate analysis of the problem and ensures mental comfort. A study aimed at developing real-time safety audits for the error correction was conducted by Ursprung et al. (2005).This study seems very much influential in the rapid management of patient safety.
In the wake of concerns about ICUs, it is important that the public be informed about the methodologies involved in the patient care at different hospitals.
This helps the patient to get mentally adapted to hospital atmosphere and eliminate all possible dilemmas while choosing the ICUs. (Runy, 2004) has previously reported interesting article that describes case studies that help in better understanding of practices adopted in ICUs in the light of errors, infrastructure and patient safety.
The practices adopted in ICU have to be improved to ensure patient safety. For this, appropriate practical expertise is central for modifying the patient care processes and assessing the outcomes. This could help in thorough evaluation of risk and propose new interventions. Stockwell & Slonim, 2006 have clearly elucidated the practical aspects of improving ICU from all corners.
It is well known that patients are susceptible to hospital fear or any kind of psychological feeling that may sometimes affect their recovery. They have to be always accompanied by dependents or other caretakers. So, the new intervention program is known as patient safety morbidity and mortality conferences (PSMMC) conducted by medical researchers brings great relief to patients and their followers (Bechtold et al., 2007). This method would tremendously improve patient care system and the required environment for its successful maintenance.
Frush, Alton, and Frush (2007) have described a new approach to hospital based patient safety program. According to this report, much of the responsibility relies on reducing complexity and variation, and increasing standardization.It is a very crucial report because the degree of patient’s concerns would be elevated if the case was made more complicated than it really appears, by the hospital mates.
This might be due to poor familiarity with the patient safety procedure or poor maintenance of the existing methodologies or guidelines to protect patients. As the overall responsibility relies on the team workers, the article had also stressed their active role in providing the amicable environment during the stay of the patients. Hence, the report is very suggestive.
(Reader, Flin and Cuthbertson, 2007) highlighted error studies regarding communication skills in the ICU. Very often, it is the defect in professional expression that creates problems and interferes with the patient safety. Say, if a technician is unable to detail a technical snag, there would be utter chaos in the ICU about what happened actually. Similarly, a caretaker or team member who fails to describe the condition of the patient to the concerned superiors would even escalate the problem and chances of risk. So there is a urgent need for improving communication among the team members of ICU. The article is therefore very informative and insightful.
Finally, patients admitted to the ICU’’s should be given freedom to express their willingness or unwillingness about the practices being adopted. For example, patients who are close to death may be willing to leave ICU or even hospital, or discontinue any controversial therapy.
Since the time of joining, the patient could have seen the hell and yearned for a freedom.
So, the hospital staff should understand the mental agony of the patient and cooperate to full extent. Schneiderman (2006) had previously highlighted the importance of ethics consultations in ICU’S. The article indicates that ethical interventions would be beneficial in avoiding cost extravaganza and treatment conflicts.
I infer here, that patient’s obligations should be given priority in ICU’’s and all possible financial implications of ICU admission should be considered and need to be handled gently to avoid any kind of legal interventions.
In a nutshell, ICU presents one of the most serious patient safety concerns in the health care sector. Earlier, it was a big issue in society due to the lack of appropriate methodologies. With the advancements in deep thinking and analysis, new patient safety systems have come into existence at various medical centers. Methods like score cards, indicators, safety audits, PSMMC and other intervention studies have taken great shape and are progressing rapidly. However, minimum worries about patient safety are still huge in the society.
Large studies are required to thoroughly evaluate the existing systems and pitfalls.
Patients participating in the study must give a written consent and finally the study has to be approved by an authorized ethical committee and selection procedure is as per the standard criteria.
Markers or predictors may have good implications for the patient safety. Hence, it is imperative that investigation is made in such direction.
Further, infrastructure and recruitment of skilled technicians need to be streamlined in ICUs. A specially dedicated team for monitoring patient safety, if staff would be beneficial.
Clinicians need to streamline the monitoring process. Health care officials need to conduct special workshops regarding patient safety both at national and international levels.
I consider that this is the best strategy as it would help to exchange opinions or ideas between different brains.
In outline, patient safety is a critical health care issue with broad spectrum of influential departments and ICU is one of them. From concerns to causalities, the importance of ICU has dramatically increased. Recent years have observed a significant growth in the ICU
methodology of patient care. However, further improvements are required by employing large medical and/or health care professionals to ensure optimum patient safety.
Berenholtz, S.M., Pustavoitau, A., Schwartz, S.J., Pronovost, P.J. (2006). How safe is my intensive care unit? Methods for monitoring and measurement Curr Opin Crit Care,13,703-8.
Longo, D.R., Hewett, J.E., Ge B., Schubert, S.(2005). The long road to patient safety: a status report on patient safety systems. JAMA, 294, 2858-65.
McLoughlin, V., Millar, J., Mattke, S., Franca, M, Jonsson, P.M., Somekh, D, Bates, D.(2006).Selecting indicators for patient safety at the health system level in OECD countries. Int J Qual Health Care, Suppl 1:14-20.
Ursprung, R, Gray, J.E., Edwards, W.H., Horbar, J.D., Nickerson, J., Plsek, P., Shiono, P.H., Suresh, G.K., Goldmann, D.A.(2005) Real time patient safety audits: improving safety every day. Qual Saf Health Care,14, 284-9.
Runy, L.A. (2004). Best practices and safety issues in the ICU. Hosp Health Netw, 78, 45-51.
Stockwell D.C., & Slonim A.D. (2006). Quality and safety in the intensive care unit. J Intensive Care Med, 21,199-210.
Bechtold, M.L., Scott, S, Nelson, K., Cox, K.R., Dellsperger, K.,C., Hall, L.,W. (2007).Educational quality improvement report: outcomes from a revised morbidity and mortality format that emphasized patient safety. Qual Saf Health Care, 16,422-7.
Valentin, A., & Bion, J.(2006). How safe is my intensive care unit? An overview of error causation and prevention. Curr Opin Crit Care, 13,697-702.
Reader, T.W., Flin, R. , & Cuthbertson, B.H.(2007). Communication skills and error in the intensive care unit. Curr Opin Crit Care, 13,732-6.
Schneiderman, L.J. (2006) Effect of ethics consultations in the intensive care unit. Crit Care Med, 34, S359-63.