The Iatroref study: medical errors are associated with symptoms of depression in ICU staff but not burnout or safety culture

Publié le 04 mai 2016 • Catégorie(s) : Conditions de travail et santé psychologique • Mot(s) clef(s) : médecins, risques psychosociaux

Auteur      Maité Garrouste-Orgeas
Auteur      Marion Perrin
Auteur      Lilia Soufir
Auteur      Aurélien Vesin
Auteur      François Blot
Auteur      Virginie Maxime
Auteur      Pascal Beuret
Auteur      Gilles Troché
Auteur      Kada Klouche
Auteur      Laurent Argaud
Auteur      Elie Azoulay
Auteur      Jean-François Timsit
Volume      41
Numéro      2
Pages      273-284
Publication      Intensive Care Medicine
ISSN      1432-1238
Date      Feb 2015
Résumé      PURPOSE: Staff behaviours to optimise patient safety may be influenced by burnout, depression and strength of the safety culture. We evaluated whether burnout, symptoms of depression and safety culture affected the frequency of medical errors and adverse events (selected using Delphi techniques) in ICUs. METHODS: Prospective, observational, multicentre (31 ICUs) study from August 2009 to December 2011. RESULTS: Burnout, depression symptoms and safety culture were evaluated using the Maslach Burnout Inventory (MBI), CES-Depression scale and Safety Attitudes Questionnaire, respectively. Of 1,988 staff members, 1,534 (77.2 %) participated. Frequencies of medical errors and adverse events were 804.5/1,000 and 167.4/1,000 patient-days, respectively. Burnout prevalence was 3 or 40 % depending on the definition (severe emotional exhaustion, depersonalisation and low personal accomplishment; or MBI score greater than -9). Depression symptoms were identified in 62/330 (18.8 %) physicians and 188/1,204 (15.6 %) nurses/nursing assistants. Median safety culture score was 60.7/100 [56.8-64.7] in physicians and 57.5/100 [52.4-61.9] in nurses/nursing assistants. Depression symptoms were an independent risk factor for medical errors. Burnout was not associated with medical errors. The safety culture score had a limited influence on medical errors. Other independent risk factors for medical errors or adverse events were related to ICU organisation (40 % of ICU staff off work on the previous day), staff (specific safety training) and patients (workload). One-on-one training of junior physicians during duties and existence of a hospital risk-management unit were associated with lower risks. CONCLUSIONS: The frequency of selected medical errors in ICUs was high and was increased when staff members had symptoms of depression.