الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Critical care medicine has been defined as ”a service offered to patients with potentially treatable conditions who may benefit from close monitoring and care.”. The critical care unit (CCU) is a discrete organizational and geographic entity for clinical activity and care, operating in cooperation with other departments in the hospital.
The outcome of patients in critical care unit (CCU) is significantly related to multiple factors including, the severity of the disease, infrastructure, trained medical staff, nursing care, medical supplies, patient age, presence of comorbidities and multiorgan failure, pre-hospital and emergency care trauma score, mechanical ventilation, length of stay in CCU, complications that occur in CCU, spreading of antimicrobial-resistant bacteria and inappropriate or suboptimal use of antibiotics.
Quality Improvement (QI) in critical care, is the constant efforts of healthcare experts, patients, payers, and organizers to create changes that will principal to improve patients ‘outcome.
Patient Safety (PS) is becoming a global concern and an essential element of health care quality. It aims to prevent or decrease hazardous events that might occur to patients while receiving health care services. Patient harm owed to hazardous events is one of the top ten reasons of mortality and incapacity globally.
Creating safe patient care environment has placed a spotlight on preventable medical errors and within healthcare organizations particularly in complex health care settings such as Critical Care Units (CCUs). Such settings represent high risk areas for hazardous events due to the nature of health care services, the large number of interventions performed, long stays and the patients’ characteristics.
The process of change requires the involvement of all stakeholders. Presence of multidisciplinary teams to ensure the implementation and evaluation of any QI strategy for QI and patient safety (PS) problems is needed.
The present study was conducted to describe the clinical and epidemiological profiles of patients admitted to the studied critical care units at Alexandria Main University Hospital (AMUH), determine the outcome of care of studied critically ill patients, compare the studied critical care units regarding the main hospital indicators and estimate the incidence of reported hazardous events.
The current study included (759) patients admitted to (5) critical care units in AMUH during the period from April 2022 to July 2022.
Results of the present study were presented in three sections:
Section I: Description of the studied critically ill patients admitted to different units during the study period.
1. Demographic characteristics of the studied critically ill patients:
• Most of critically ill patients admitted to different units during the study period were males with a percentage of (51.9%)
• Most of critically ill patients admitted to different units during the study period were from Alexandria with a percentage of (73.8%).
• The mean age of the studied critically ill patients during the study period ranged from 1-95 years with a mean of (52.2 ± 21.25) years.
2. Clinical data of the studied critically ill patients on admission:
• More than 2/3 of the patients admitted to critical care units during the study period were referred from emergency department.
• More than 2/3 (74.8%) of the patients at different critical care units during the study period were admitted due to medical causes
• The median APACHE II score of the critically ill patients on admission to different critical care units during the study period was 15.
• The median GCS of the critically ill patients on admission to different critical care units during the study period was 10.
3. Mechanical ventilation (MV):
• Most of the critically ill patients (84.5%) admitted to different critical care units during the study period were mechanically ventilated.
• More than one third (36.7%) of the patients were successfully weaned from MV.
• Nearly two thirds (66.7%) died before weaning trial.
• The percentage of tracheostomized patients was (11.3%).
Section II: Outcome of care and hazardous events among the studied critically ill patients and factors affecting them.
1. Outcome of care at critical care units:
• The percentage of non survivors was (53.2%).
• Nearly half (46.8%) the patients were survived.
• Unit 4 had the best outcome with the highest percentage of survivors (58.4%).
• Most of those who did not survive were admitted to unit 5 with the highest percentage of non survivors (63.7%).
• The median age for non survivors was higher than those who survived.