Incidence of Adverse Events and Negligence in Hospitalized Patients

Brennan, Troyen A.; Leape, Lucian L.; Laird, Nan M.; Hebert, Liesi E.; Localio, A. Russell; Lawthers, Ann G.; Newhouse, J P; Weiler, Paul C.; Hiatt, Howard H.

doi:10.1056/nejm199102073240604

Cited by 3,806 publications

(1,023 citation statements)

References 6 publications

(1 reference statement)

Supporting

Mentioning

912

Contrasting

Unclassified

Order By: Relevance

“…[1][2][3][4][5]15 In contrast to the historic "see one, do one, teach one" model of procedure supervision, we identified a high rate of senior clinician involvement in bedside procedures throughout the hospital. While the MPS was significantly more likely to document ultrasound use and to avoid femoral CVC, we identified an encouragingly high rate of compliance with these safety process measures on the primary services as well.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Impact of a Medical Procedure Service on Patient Safety, Procedure Quality and Resident Training Opportunities

Tukey

Wiener

2013

J GEN INTERN MED

View full text Add to dashboard Cite

BACKGROUND: At some academic hospitals, medical procedure services are being developed to provide supervision for residents performing bedside procedures in hopes of improving patient safety and resident education. There is limited knowledge of the impact of such services on procedural complication rates and resident procedural training opportunities. OBJECTIVE: To determine the impact of a medical procedure service (MPS) on patient safety and resident procedural training opportunities. DESIGN: Retrospective cohort analysis comparing characteristics and outcomes of procedures performed by the MPS versus the primary medical service. PARTICIPANTS: Consecutive adults admitted to internal medicine services at a large academic hospital who underwent a bedside medical procedure (central venous catheterization, thoracentesis, paracentesis, lumbar puncture) between 1 July 2010 and 31 December 2011. MAIN MEASURES: The primary outcome was a composite rate of major complications. Secondary outcomes included resident participation in bedside procedures and use of "best practice" safety process measures. KEY RESULTS: We evaluated 1,707 bedside procedures (548 by the MPS, 1,159 by the primary services). There were no differences in the composite rate of major complications (1.6 % vs. 1.9 %, p=0.71) or resident participation in bedside procedures (57.0 % vs. 54.3 %, p=0.31) between the MPS and the primary services. Procedures performed by the MPS were more likely to be successfully completed (95.8 % vs. 92.8 %, p=0.02) and to use best practice safety process measures, including use of ultrasound guidance when appropriate (96.8 % vs. 90.0 %, p=0.0004), avoidance of femoral venous catheterization (89.5 vs. 82.7 %, p=0.02) and involvement of attending physicians (99.3 % vs. 57.0 %, p<0.0001). CONCLUSIONS: Although use of a MPS did not significantly affect the rate of major complications or resident opportunities for training in bedside procedures, it was associated with increased use of best practice safety process measures.KEY WORDS: bedside procedures; medical education; medical procedure services.

show abstract

Section: Discussionmentioning

confidence: 99%

“…In the Medical Practice Study, procedural complications were the second most common cause of adverse events among hospitalized patients. 3,4 Although serious complications are rare, they can be life threatening, raising questions about whether these procedures should be performed by housestaff alone.…”

Section: Introductionmentioning

confidence: 99%

The Impact of a Medical Procedure Service on Patient Safety, Procedure Quality and Resident Training Opportunities

Tukey

Wiener

2013

J GEN INTERN MED

View full text Add to dashboard Cite

show abstract

“…The Harvard Medical Practice Study (Brennan et al, 1991) using data from 30,121 randomly selected patient records identified a total of 1278 adverse events. From this figure it was estimated that adverse events occurred in 3.7% of hospitalisations and of these adverse events 27.6% were due to negligence.…”

Section: Medical Errormentioning

confidence: 99%

“…Many of the major medical error studies have highlighted medication errors as a cause of adverse events suffered by patients (Bates et al, 1995;Leape et al, 1995;Brennan 1991Kohn et al, 1999. Approximately a quarter of all claims to the Medical Defence Union relate to drugs.…”

Section: Medication Errormentioning

confidence: 99%

Applying hierarchical task analysis to medication administration errors

2006

View full text Add to dashboard Cite

Medication use in hospitals is a complex process and is dependent on the successful interaction of health professionals functioning within different disciplines. Errors can occur at any one of the five main stages of prescribing, documenting, dispensing or preparation, administering and monitoring. The responsibility for the error is often placed on the nurse, as she or he is the last person in the drug administration chain whilst more pressing underlying causal factors remain unresolved.\ud \ud This paper demonstrates how hierarchical task analysis can be used to model drug administration and then uses the systematic human error reduction and prediction approach to predict which errors are likely to occur. The paper also puts forward design solutions to mitigate these errors

show abstract

“…The inappropriate use of medications has been estimated to account for 19.4% of all iatrogenic injuries in the Medical Practice Study and is thus a cause for concern [2]. However, different methodologies adopted by researchers have made it difficult to estimate the true incidence of medication errors, which therefore remains controversial.…”

Section: Introductionmentioning

confidence: 99%

The role of perception in Medication Errors : Implications for Non-Technological Interventions

Taneja

Wiegmann

2004

Medical Journal Armed Forces India

View full text Add to dashboard Cite

Incidence of Adverse Events and Negligence in Hospitalized Patients

Abstract: There is a substantial amount of injury to patients from medical management, and many injuries are the result of substandard care.

Cited by 3,806 publications

References 6 publications

The Impact of a Medical Procedure Service on Patient Safety, Procedure Quality and Resident Training Opportunities

The Impact of a Medical Procedure Service on Patient Safety, Procedure Quality and Resident Training Opportunities

Applying hierarchical task analysis to medication administration errors

The role of perception in Medication Errors : Implications for Non-Technological Interventions

Contact Info

Product

Resources

About