Full Disclosure of Adverse Events to Patients and Families in the ICU: Wouldn't You Want to Know? (Intensive Care Units‪)‬

In the past decade, research has shown that there is a growing concern about the number of adverse events in our health care system. The 2004 Canadian Adverse Events Study identified adverse events arising from the delivery of health care services as a significant problem in Canadian hospitals (Canadian Patient Safety Institute, 2008). The overall incidence was 7.5% of adverse events in that study, suggesting that of the 2.5 million hospital admissions annually, about 185,000 of those were associated with an adverse event and close to 70,000 of those were potentially preventable. Interestingly, it was noted that most of these took place in teaching hospitals. The study also indicated that the majority of patients who experienced an adverse event recovered without permanent disability. However, a significant number were also noted to have an increased length of hospital stay, as well as a temporary disability after discharge home. Despite the common goals and the best efforts of the health care team, outcomes may differ from what is desired or anticipated (Swiggum & Wallace, 2009). Errors and adverse events occur more frequently in intensive care units (ICU) than in any other setting (Boyle, O'Connell, Platt, & Albert, 2006). The complexity of illness and trauma exponentially increases the risk of error and subsequent adverse events. In fact, errors and adverse events occur more often in ICUs, as patients frequently suffer from severe, multiple-system illnesses that require numerous interventions involving decision-making and planning from a number of health care providers. In general, patients with co-morbidities require more testing, monitoring and treatment, therefore increasing the risk of overlooking a critical physical finding, an important laboratory test, or a radiographic abnormality. Consequently, the patient has a greater risk of suffering from treatment- or procedure-related complications (Boyle et al., 2006).