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Table 1 List of the items in the structured reporting form.

From: Reporting of unintended events in an intensive care unit: comparison between staff and observer

ICU where the UE has occurred Shift of UE detection: Morning
Reporter's qualification: Nurse, Physician Afternoon
Date of detection Night
Type of UE: Problems with airway/mechanical ventilation Type of UE: Problems with catheter/drain/probes
   Accidental extubation    Unplanned removal
   Unplanned reintubation    Dislodgement
   Tracheal tube obstruction    Inappropriate opening
   Tracheal cuff leakage    Inappropriate disconnection
   Incorrect ventilator setting  
   Ventilator auto cycling Type of UE: Problems with medication
   Turn off of heated humidifier    Prescription error
   Turn off of ventilator alarms    Transcription error
     Wrong dose
Type of UE: patient management:    Wrong route of administration
   Delayed treatment  
   Incorrect patient positioning Type of UE: unit management
   Documentation lacking    Organization
   Documentation reported incorrectly or inaccurately    Communication
     Equipment failure
Turn off of oxygen saturationalarm  
  Other problem:................................
Severity of the unintended event  
   Intercepted by the staff  
   Self resolving  
   Minor  
   Serious