Consequences of adverse events with handling of the orotracheal cannula in intensive care unit

Objectives

To identify the adverse events regarding handling of the orotracheal cannula in the ICU and to evaluate its impact on the patient's severity and on the nursing workload.

Method

Data were prospectively collected during a 3-month period, in two general ICUs of a hospital in the city of São Paulo, Brazil, using a file card to record the occurrences. Patient's severity and nursing workload were evaluated 24 hours before and 24 hours after the occurrence of the event, respectively, by means of the Simplified Acute Physiology Score (SAPS II) and the Therapeutic Intervention Scoring System-28 (TISS-28).

Results

In the period of the study 212 patients were admitted, 47 (22%) of which were victims of 80 adverse events during the their stay at the ICU. There was a total of 19 (24.0%) adverse events regarding handling of the orotracheal cannula. Of these were observed 14 (73.0%) not programmed withdrawals of the orotracheal cannula, three (16%) blockages of the cannula for secretion corks and two (11%) cuffs emptied. A statistically significant difference was found both in the SAPS II (P < 0.042) and TISS-28 (P < 0.001), evidenced before and after the event. One verified reduction of the patient's severity, but an increase on the nursing workload as a consequence of these events.

Conclusions

The results of this investigation reinforce the need for investments to qualify professionals to work with critical patients as a major measurement for safety nursing assistance and quality in the ICU.