Risk Factors of Patient-Related Safety Events during Active Mobilization for Intubated Patients in Intensive Care Units—A Multi-Center Retrospective Observational Study
Hajime Katsukawa, Kohei Ota, Keibun Liu, Yasunari Morita, Shinichi Watanabe, Kazuhiro Sato, Kenzo Ishii, Daisetsu Yasumura, Yo Takahashi, Takafumi Tani, Hitoshi Oosaki, Tomoya Nanba, Ryo Kozu, Toru Kotani
Abstract
The aim of this study is to clarify the incidence and risk factors of patient-related safety events (PSE) in situations limited to intubated patients in which active mobilization, such as sitting on the edge of the bed/standing/walking, was carried out. A multi-center retrospective observational study was conducted at nine hospitals between January 2017 and March 2018. The safety profiles and PSE of 87 patients were analyzed. PSE occurred in 10 out of 87 patients (11.5%) and 13 out of 198 sessions (6.6%). The types of PSE that occurred were hypotension (8, 62%), heart rate instability (3, 23%), and desaturation (2, 15%). Circulation-related events occurred in 85% of overall cases. No accidents, such as line/tube removal or falls, were observed. The highest incidence of PSE was observed during the mobilization level of standing (8 out of 39 sessions, 20.5%). The occurrence of PSE correlated with the highest activity level under logistic regression analysis. Close vigilance is required for intubated patients during active mobilization in the standing position with regard to circulatory dynamics.