The occurrence of adverse events potentially attributable to nursing care in medical units: Cross sectional record review (original) (raw)
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Journal of Advanced Nursing, 2021
Aims: To identify the costs associated with nurse sensitive adverse events and the impact of these events on patients' length of stay. Design: Retrospective cohort study using administrative hospital data. Methods: Data were sourced from patient discharge information (N = 5544) from six acute wards within three hospitals (July 2016-October 2017). A retrospective patient record review was undertaken by extracting data from the hospitals' administrative systems on inpatient discharges, length of stay and diagnoses; eleven adverse events sensitive to nurse staffing were identified within the administrative system. A negative binomial regression is employed to assess the impact of nurse sensitive adverse events on length of stay. Results: Sixteen per cent of the sample (n = 897) had at least one nurse sensitive adverse event during their episode of care. The model revealed when age, gender, admission type and complexity are controlled for, each additional nurse sensitive adverse event experienced by a patient was associated with an increase in the length of stay beyond the national average by 0.48 days (p = .001). Applying this to the daily average cost of inpatient stay per patient (€1456), we estimate the average cost associated with each nurse sensitive adverse event to be €694. Extrapolating this nationally, the economic cost of nurse sensitive adverse events to the health service in Ireland is estimated to be €91.3 million annually. Conclusion: These potentially avoidable events are associated with a significant economic burden to health systems. The estimates provided here can be used to inform and prepare the way for future economic evaluations of nurse staffing initiatives that aim to improve care and safety. Impact: As many of these nurse sensitive adverse events are avoidable, in addition to patient benefits, there is a potential substantial financial return on investment from strategies such as improved nurse staffing that can reduce their occurrence. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Adverse Events in Hospital Care and Nursing
2020
The proposed reflection intends to raise awareness among nursing professionals about the safe attitudes in care delivery as well as to know and discuss the occurrence of adverse events in hospital care in the different areas and the most frequent types of errors that occur in the provision of this care. The text has a theoretical-reflective approach, built from the critical reading of articles, in order to evaluate and summarize the information found. The safety culture that requires change of posture and behavior in patient care needs to be implemented with greater solidity, monitored and required in all phases of care. It is considered important to review the conduct in the event of errors and adverse events. Thus, investment in continuing education, the dialogue between medical and other caregivers, should be a constant in hospital care.
Improving patient safety: how and why incidences occur in nursing care
Revista da Escola de Enfermagem da USP, 2013
Investigación cuantitativa de tipo transversal que analizó los incidentes relacionados a los cuidados de enfermería, por medio de la metodología del análisis causa -raíz. Fue realizado en una unidad de cuidados intensivos de un hospital público de Santiago de Chile. El universo fue compuesto por 18 incidentes relacionados a los cuidados de enfermería ocurridos de enero a marzo del 2012. La muestra fue constituida por seis casos relacionados a medicamentos y retiro no planificado de artefactos terapéuticos. Los factores relacionados fueron: tarea y tecnología, equipo de trabajo, profesional, paciente y ambiente. En el análisis se constató que los casos presentaron factores relacionados semejantes, concluyendo que los puntos vulnerables del sistema son en su mayoría, los responsables por la ocurrencia de incidentes. Se concluye que el análisis de causa -raíz permite la identificación de estos puntos vulnerables y, por medio de recomendaciones, posibilita la gestión proactiva en la prevención de fallas del sistema.
Nursing care quality and adverse events in US hospitals
Journal of Clinical Nursing, 2010
Aim-To examine the association between nurses' reports of unmet nursing care needs and their reports of patients' receipt of the wrong medication or dose, nosocomial infections and patient falls with injury in hospitals.
Adverse Events on Hospitalized Patients: A Barely Known Reality
SM Journal of Nursing, 2017
Introduction: Currently, the patient's safety is a fundamental component of the health care quality, more specifically of the nursing care quality and it constituted a preoccupation to the hospital managers by the influence it has on the cost of the care. The incurrence of Adverse Events (AE) associated to the nursing care is underestimated in Portugal, not allowing a real knowledge about this issue. Material and Methods: A descriptive study, cross-sectional and quantitative approach with a sample of 628 nurses, who work in 43 internment services at 8 Portuguese hospitals. Results: The psychometric properties evaluation of the Subscale of Assessing Risk and Occurrence of Adverse Events, demonstrated its suitability to evaluate the phenomenon in study. The Risk/Occurrence of Medication Errors proved to be the typology of AE that occurs less frequently or which is less likely to occur (AE_7 M=2, 20). For its turn, the Risk/Occurrence of HCAI (Health Care Associated Infections) is the type of AE that showed a higher average value (AE_6 M=4, 21). The Risk of Falls and Pressure Ulcers is moderate (AE_8 M=3.07), but the Occurrence of Falls and Pressure Ulcers is low (AE_9 M= 2.33). Conclusion: The characterization of AE associated to the nursing care in terms of typology and occurrence frequency is very relevant, allowing us to analyze its causes, to develop and implement corrective and preventive measures to minimize the damage and improve the patients' safety.
The Nurses' Role in Patient Safety -Literature Review
Aim/Objective: Among the many factors that play an essential role in the patient's treatment and recovery process, safety occupies a vital place. On the other hand, providing patient safety is influenced by equally crucial factors, such as the level and quality of medical personnel's education, experience, working environment, attitude, and others. Nurses have an essential role in patient safety. Therefore, the article focuses on the nurse's role in patient safety and the impact of problematic issues in the nursing profession on it. Background: Each person is a potential patient who needs health services, including nursing care. Nursing belongs to the number of professions in demand and will be in the future. However, in the nursing profession, new problems appear and deepen every year, including shortages, problems related to education, lack of nurse pedagogues, and others. All of these affects or endanger access and receiving to qualified, safe medical services, including patient safety. Design and Methods: The article reviews and describes patient safety problems globally through secondary data analyses published in SCOPUS and PubMed from 2015-2022. Results and Conclusions: Patient safety is not the responsibility of only one link of the medical staff, the doctor, or the nurse. It depends on the activities of each clinic member, the level of education, competence, the knowledge-attitude of the patient's safety, and the shared vision/attitude towards safety issues in the working environment. As medical staff also, patient involvement is essential for patient safety. Their awareness and providing patient education will reduce risks related to patient safety.
International Journal of Nursing Studies, 2019
Background: For decades, patient safety has been recognized as a critical global healthcare issue. However, there is a gap of knowledge of all types of adverse events sensitive to nursing care within hospitals in general and within orthopaedic care specifically. Objectives: The aim of this study is to explore the incidence and nature of nursing-sensitive adverse events following elective or acute hip arthroplasty at a national level. Design: A retrospective multicenter cohort study. Outcome variables: Nursing-sensitive adverse events, preventability, severity and length of stay. Methods: All patients, 18 years or older, who had undergone an elective (degenerative joint disease) or acute (fractures) hemi or total hip arthroplasty surgery at 24 hospitals were eligible for inclusion. Retrospective reviews of weighted samples of 1998 randomly selected patient records were carried out using the Swedish version of the Global Trigger Tool. The patients were followed for readmissions up to 90 days postoperatively throughout the whole country regardless of index hospital. Results: A total of 1150 nursing-sensitive adverse events were identified in 728 (36.4%) of patient records, and 943 (82.0%) of the adverse events were judged preventable in the study cohort. The adjusted cumulative incidence regarding nursing-sensitive adverse events for the study population was 18.8%. The most common nursing-sensitive adverse event types were different kinds of healthcare-associated infections (40.9%) and pressure ulcers (16.5%). Significantly higher proportions of nursing-sensitive adverse events were found among female patients compared to male, p < 0.001, and patients with acute admissions compared to elective patients, p < 0.001. Almost half (48.5%) of the adverse events were temporary and of a less severe nature. On the other hand, 592 adverse events were estimated to have contributed to 3351 extra hospital days. Conclusions: This study shows the magnitude of nursing-sensitive adverse events. We found that nursingsensitive adverse events were common, in most cases deemed preventable and were associated with different kinds of adverse events and levels of severity in orthopaedic care. Registered nurses play a vital role within the interdisciplinary team as they are the largest group of healthcare professionals, work 24/7 and spend much time at the bedside with patients. Therefore, nursing leadership at all hospital levels must assume responsibility for patient safety and authorize bedside registered nurses to deliver high-quality and sustainable care to patients.
PloS one, 2024
Although, strengthening patient safety competencies in nursing has been emphasized for enhancing quality care and patient safety. However, little is known about the association of nurses' perceptions of patient safety competency with adverse nurse outcomes in Iranian hospitals. This study aimed to measure nurses' levels of patient safety competency in the hospitals of Iran and examines the relationship between patient safety competency with the occurrence and reporting of adverse events (AEs). This cross-sectional research was applied in eight teaching hospitals in Tehran, Iran, between August and December 2021. A sample of 511 nurses was randomly selected using the table of random numbers. The validated Patient Safety Competency Self-Evaluation questionnaire was used. Furthermore, two questions were used to measure the incidence and reporting of AEs. Data analysis was performed using descriptive statistics, independent t-tests, and two binary logistic regression models through SPSS version 24.0. The mean patient safety competency score was 3.34 (SD = 0.74) out of 5.0; 41.5% of nurses rated their patient safety competency as less than 3. Among subscales, "skills of patient safety" scores were the highest, and "knowledge of patient safety" scores were the lowest. Nurses with higher Knowledge and Attitude scores were less likely to experience the occurrence of AEs (OR = 1.50 and OR = 0.58, respectively). Regarding AEs reporting, nurses with higher Skill and Attitude scores were 2.84 and 1.67 times, respectively, more likely to report AEs (OR = 2.84 and OR = 3.44, respectively). Our results provide evidence that enhancing PSC leads to reduced incidence of AEs and increased nurses' performance in reporting. Therefore, it is recommended that managers of hospitals should enhance the patient safety competency of nurses in incidents and reporting of patient safety adverse outcomes through quality expansion and training. Additionally, researchers should carry out further research to confirm the findings of the PLOS ONE