Differences in the Incidence of Adverse Events in Acute Care Hospitals: Results of a Multicentre Study (original) (raw)
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Variation in the rates of adverse events between hospitals and hospital departments
International Journal for Quality in Health Care, 2011
Objective. The objective of this study was to analyze the variation in the rates of adverse events (AEs), and preventable AEs, between hospitals and hospital departments in order to investigate the room for improvement in reducing AEs at both levels. In addition, we explored the extent to which patient, department and hospital characteristics explain differences in the rates of AEs.
International journal for quality in health care : journal of the International Society for Quality in Health Care, 2018
To analyse the variation in the rate of adverse events (AEs) between acute hospitals and explore the extent to which some patients and hospital characteristics influence the differences in the rates of AEs. Retrospective cohort study. Chi-square test for independence and binary logistic regression models were used to identify the potential association of some patients and hospital characteristics with AEs. Nine acute Portuguese public hospital centres. A random sample of 4250 charts, representative of around 180 000 hospital admissions in 2013, was analysed. To measure adverse events based on chart review. Rate of AEs. Main results: (i) AE incidence was 12.5%; (ii) 66.4% of all AEs were related to Hospital-Acquired Infection and surgical procedures; (iii) patient characteristics such as sex (female 11%; male 14.4%), age (≥65 y 16.4%; <65 y 8.5%), admission coded as elective vs. urgent (8.6% vs. 14.6%) and medical vs. surgical Diagnosis Related Group code (13.4% vs. 11.7%), all wi...
2019
OBJECTIVE: To analyse the variation in the rate of adverse events (AEs) between acute hospitals and explore the extent to which some patients and hospital characteristics influence the differences in the rates of AEs. DESIGN: Retrospective cohort study. Chi-square test for independence and binary logistic regression models were used to identify the potential association of some patients and hospital characteristics with AEs. SETTING: Nine acute Portuguese public hospital centres. PARTICIPANTS: A random sample of 4250 charts, representative of around 180 000 hospital admissions in 2013, was analysed. INTERVENTION: To measure adverse events based on chart review. MAIN OUTCOME MEASURE: Rate of AEs. RESULTS: Main results: (i) AE incidence was 12.5%; (ii) 66.4% of all AEs were related to Hospital-Acquired Infection and surgical procedures; (iii) patient characteristics such as sex (female 11%; male 14.4%), age (≥65 y 16.4%; <65 y 8.5%), admission coded as elective vs. urgent (8.6% vs. 14.6%) and medical vs. surgical Diagnosis Related Group code (13.4% vs. 11.7%), all with p < 0.001, were associated with a greater occurrence of AEs. (iv) hospital characteristics such as use of reporting system (13.2% vs. 7.1%), being accredited (13.7% vs. non-accredited 11.2%), university status (15.9% vs. non-university 10.9%) and hospital size (small 12.9%; medium 9.3%; large 14.3%), all with p < 0.001, seem to be associated with a higher rate of AEs. CONCLUSIONS: We identified some patient and hospital characteristics that might influence the rate of AEs. Based on these results, more adequate solutions to improve patient safety can be defined.
2014
Background: Several review studies have shown that 3.4% to 16.6% of patients in acute care hospitals experience one or more adverse events. Adverse events (AEs) in hospitals constitute a significant problem with serious consequences and a challenge for public health. The occurrence of AEs in Portuguese hospitals has not yet been systematically studied. The main purpose of this study is to estimate the incidence, impact and preventability of adverse events in Portuguese hospitals. It is also our aim to examine the feasibility of applying to Portuguese acute hospitals the methodology of detecting AEs through record review, previously used in other countries. Methods: This work is based on a retrospective cohort study and was carried out at three acute care hospitals in the Administrative Region of Lisbon. The identification of AEs and their impact was done using a two-stage structured retrospective medical records review based on the use of 18 screening criteria. A random sample of 1,669 medical records (representative of 47,783 hospital admissions) for the year 2009 was analyzed. Results: The main results found in this study were an incidence rate of 11.1% AEs, of which around 53.2% were considered preventable. The majority of AEs were associated with surgical procedures (27%), drug errors (18.3%) and hospital acquired infections (12.2%). Most AEs (61%) resulted in minimal or no physical impairment or disability, and 10.8% were associated with death. In 58.6% of the AEs' cases, the length of stay was prolonged on average 10.7 days. Additional direct costs amounted to €470,380.00. Conclusion: The magnitude of these results was critical, reinforcing the need of more detailed studies in this area. The knowledge of the incidence and nature of AEs that occur in hospitals should be seen as a first step towards the improvement of quality and safety in health care.
Occurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem
Objectives: to analyze the incidence of preventable adverse events related to health care in adult patients admitted to public hospitals in Brazil. Methods: observational, analytical, retrospective study based on medical records review. Results: medical records from 370 patients were evaluated, 58 of whom had at least one adverse event. The incidence of adverse events corresponded to 15.7%. Adverse events were predominantly related to healthcare-related infection (47.1%) and procedures (24.5%). Regarding the adverse event severity, 13.7% were considered mild, 51.0% moderate, and 35.3% severe. 99% of adverse events were classified as preventable. Patients admitted to the emergency room had a 3.73 times higher risk for adverse events. Conclusions: this study’s results indicate a high incidence of avoidable adverse events and highlight the need for interventions in care practice.
Exploring the causes of adverse events in hospitals and potential prevention strategies
Quality & safety in health care, 2010
To examine the causes of adverse events (AEs) and potential prevention strategies to minimise the occurrence of AEs in hospitalised patients. For the 744 AEs identified in the patient record review study in 21 Dutch hospitals, trained reviewers were asked to select all causal factors that contributed to the AE. The results were analysed together with data on preventability and consequences of AEs. In addition, the reviewers selected one or more prevention strategies for each preventable AE. The recommended prevention strategies were analysed together with four general causal categories: technical, human, organisational and patient-related factors. Human causes were predominantly involved in the causation of AEs (in 61% of the AEs), 61% of those being preventable and 13% leading to permanent disability. In 39% of the AEs, patient-related factors were involved, in 14% organisational factors and in 4% technical factors. Organisational causes contributed relatively often to preventable ...
BMC health services research, 2007
Various international studies have shown that a substantial number of patients suffer from injuries or even die as a result of care delivered in hospitals. The occurrence of injuries among patients caused by health care management in Dutch hospitals has never been studied systematically. Therefore, an epidemiological study was initiated to determine the incidence, type and impact of adverse events among discharged and deceased patients in Dutch hospitals. Three stage retrospective patient record review study in 21 hospitals of 8400 patient records of discharged or deceased patients in 2004. The records were reviewed by trained nurses and physicians between August 2005 and October 2006. In addition to the determination of presence, the degree of preventability, and causes of adverse events, also location, timing, classification, and most responsible specialty of the adverse events were measured. Moreover, patient and admission characteristics and the quality of the patient records we...
Bmc Health Serv Res, 2007
Background: Various international studies have shown that a substantial number of patients suffer from injuries or even die as a result of care delivered in hospitals. The occurrence of injuries among patients caused by health care management in Dutch hospitals has never been studied systematically. Therefore, an epidemiological study was initiated to determine the incidence, type and impact of adverse events among discharged and deceased patients in Dutch 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.
Eurosurveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin
Surveillance of healthcare associated infections is an overlooked parameter of good clinical practice in most healthcare institutions, due to the workload demanded in the absence of adequate IT-systems. The aim of the present study was to investigate whether a simple protocol could be used to estimate the burden of healthcare associated infections in three university hospitals in Huddinge in Sweden, Riga in Latvia and Vilnius in Lithuania and form the basis for initiating a long term follow up system. The medical records of all patients receiving antibiotics were reviewed according to a standardised protocol, focusing on the indications for the drugs and on the frequency of hospital acquired infection (HAI) in a point-prevalence survey. Only comparable specialties were included. The proportion of patients treated with antibiotics (prophylaxis not included) were 63/280 (22%) in Huddinge, 73/649 (11%) in Riga and 99/682 (15%) in Vilnius. The proportion of admitted patients treated for...