Incidence of adverse incidents in residential aged care

Abstract

Objective Adverse incident research within residential aged care facilities (RACFs) is increasing and there is growing awareness of safety and quality issues. However, large-scale evidence identifying specific areas of need and at-risk residents is lacking. This study used routinely collected incident management system data to quantify the types and rates of adverse incidents experienced by residents of RACFs. Methods A concurrent mixed-methods design was used to examine 3 years of incident management report data from 72 RACFs in New South Wales and the Australian Capital Territory. Qualitative thematic analysis of free-text incident descriptions was undertaken to group adverse incidents into categories. The rates and types of adverse incidents based on these categories were calculated and then compared using incidence rate ratios (IRRs). Results Deidentified records of 11 987 permanent residents (aged ≥65 years; mean (±s.d.) age 84 ± 8 years) from the facilities were included. Of the 60 268 adverse incidents, falls were the most common event (36%), followed by behaviour-related events (33%), other impacts and injuries (22%) and medication errors (9%). The number of adverse incidents per resident ranged from 0 (42%) to 171, with a median of 2. Women (IRR 0.804; P < 0.001) and residents with low care needs (IRR 0.652; P < 0.001) were significantly less likely to adverse incidents compared with men and residents with high care needs respectively. Conclusion This study demonstrates that data already collected within electronic management systems can provide crucial baseline information about the risk levels that adverse incidents pose to older Australians living in RACFs. What is known about the topic? To date, research into aged care adverse incidents has typically focused on single incident types in small studies involving mitigation strategies. Little has been published quantifying the multiple adverse incidents experienced by residents of aged care facilities or reporting organisation-wide rates of adverse incidents. What does this paper add? This paper adds to the growing breadth of Australian aged care research by providing baseline information on the rates and types of adverse incidents in RACFs across a large and representative provider. What are the implications for practitioners? This research demonstrates that the wealth of data captured by aged care facilities’ incident management information systems can be used to provide insight into areas of commonly occurring adverse incidents. Better use of this information could greatly enhance strategic planning of quality improvement activities and the care provided to residents.

A Scoping Review of Adverse Incidents Research in Aged Care Homes: Learnings, Gaps, and Challenges

“…The search strategy used keywords of “aged care” or “nursing home” or “residential aged care facility” or “Homes for the Aged” or “Long Term Care” coupled with either “Incident$”, “adverse event$”, “adverse outcome$”. Additional searches were conducted using keywords based on types of adverse incidents that are the most commonly reported in Australian aged care homes (e.g., falls) ( St Clair et al, 2021 ).…”

Prevalence and Preventability of Adverse Medicine Events in a Sample of Australian Aged-Care Residents: A Secondary Analysis of Data from the ReMInDAR Trial

“…The studies included in the review tended to address AEs associated with specific classes or types of medicines, and the overall prevalence of AEs due to medicines was not reported [ 13 ]. A study assessing AEs in 72 aged-care facilities in New South Wales and the Australian Capital Territory between 2013 and 2016 found 60,268 AEs documented over the 3-year period [ 14 ]. In this study, AEs were categorised as falls, behavioural incidents, medication incidents (including medication errors or missed doses) and impact or injuries (AEs not falling into the other three categories).…”

“…In this study, AEs were categorised as falls, behavioural incidents, medication incidents (including medication errors or missed doses) and impact or injuries (AEs not falling into the other three categories). Falls (37% of AEs) and behavioural incidents (33%) were most common, with medicine incidents accounting for 9% of AEs [ 14 ]. Although this study provides some insight into AEs due to medicines in the aged-care setting, it is likely to have underestimated their extent.…”