Incidentes de seguridad del paciente notificados antes y después del inicio de la pandemia de COVID-19 en atención primaria en Tarragona

Gens-Barberà, Montserrat; Hernández-Vidal, Núria; Castro-Muniain, Carles; Hospital-Guardiola, I; Oya-Girona, Eva Maria; Bejarano-Romero, Ferran; Rey-Reñones, Cristina; Martín-Luján, Francisco

doi:10.1016/j.aprim.2021.102217

Cited by 3 publications

(11 citation statements)

References 19 publications

(24 reference statements)

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“…Although no publications were found that compare PSIHs between the pre-pandemic and current times, some studies have compared PSIHs before and during the pandemic. These are based on incident reporting systems [15][16] and did not report the severity of PSIH to have worsened during the pandemic, which is in agreement with the ndings of the present research.…”

Section: Discussionsupporting

confidence: 91%

“…Only a signi cant increase in diagnostic errors was found (excluding diagnostic tests that were in a separate category). One of the aforementioned studies also reported a greater number of diagnostic error reports during the pandemic [15]. The factors that could explain such an increase have been described [1-6, 10, 13-14]: disruption of routine care, shortage of resources, care reorganisation, overload, remote care, technological tools, or losses to follow-up.…”

Section: Discussionmentioning

confidence: 99%

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Post-pandemic patient safety: Have the characteristics of incidents with harm changed? Comparative observational study in primary care via review of medical records with a trigger tool

González,

Safont,

Arroyo

et al. 2024

Preprint

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Background. The COVID-19 pandemic generated or accelerated healthcare changes, some of which persist thereafter (e.g., healthcare reorganisation, remote consultation). Such changes entail novel risks for patient safety. Methods. Aim. To compare the characteristics of patient safety incidents with harm (PSIH) in primary care before the pandemic and at present. Design and setting. Cross-sectional, comparative, observational study conducted within the entire Primary Care Service of the Madrid region with observations at two time points (2018 and 2021/2022). Participants. Patients >18 years of age with at least one consultation in the previous year. The necessary sample size was established at N1=2,000 for the first time point and N2=2,700 for the second. Sampling was performed by simple randomisation for the first group and by clusters followed by simple randomisation for the second. Main measurements. Age, gender, presence of PSIH in the medical record, and characteristics of the PSIH, specifically avoidability, severity, place of occurrence, nature, and contributory factors. Triggers validated in primary care were employed to screen the patients’ medical records and those containing any trigger were reviewed by three nurse-physician teams who underwent previous training. Analysis. Comparative analysis using Fisher’s exact test. Results. A total of 63 PSIHs and 25 PSIHs were found for the first and second samples, respectively. The comparison of the characteristics of PSIH before the pandemic and currently was: avoidable 62% vs. 52% (p=0.47), mild 51% vs. 48% (p=0.57), in the primary care setting 73% vs. 64% (p=0.47), respectively. Although no statistically significant differences were observed globally in the nature of the incidents (p=0.13), statistically significant differences were found for diagnostic errors, with pre-pandemic rates of 6% vs. 20% at present (p<0.05). Finally, no significant differences were found in the contributory factors. Conclusions. No differences were found in the avoidability, severity, place of occurrence, or contributory factors of PSIHs before the pandemic and currently. In terms of the nature of these incidents, the outcomes revealed an increase in diagnostic errors (excluding diagnostic tests), which could be attributed to a greater frequency of remote consultations and a decrease in the longitudinality of care resulting from the shortage of professionals.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Post-pandemic patient safety: Have the characteristics of incidents with harm changed? Comparative observational study in primary care via review of medical records with a trigger tool

González,

Safont,

Arroyo

et al. 2024

Preprint

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“…El descenso fue mayor en AP registrándose solo un tercio de las notificaciones previas, que, en hospitales, donde se registró un 71% de niveles previos. En el estudio de Gens-Barberá et al centrado en AP observaron un descenso incluso ligeramente superior 5 (más de un 75%). Podría deberse a un incremento de la actividad asistencial global sobre años previos (claramente superior en AP) o que, pasada la primera ola y esa excepcional sobrecarga, en la desescalada y en las siguientes olas, el rastreo y realización de pruebas diagnósticas de infección activa en AP supusiese una carga adicional que produjera la no recuperación de la normalidad previa.…”

Section: Discussionunclassified

“…Sorprende que no aumentaran tipos como valoración clínica, cuidados y procedimientos terapéuticos, aunque la disminución de este último podría deberse a que dejaron de realizarse los no urgentes durante los picos de las olas. En AP los IS relacionados con gestión organizativa y citaciones crecieron proporcionalmente, lo que coincide con el estudio de Gens-Barberá et al 5 . Esto podría revelar los riesgos detectados en los cambios en la organización del equipo y la gestión del acceso que supuso la pandemia.…”

Section: Discussionunclassified

“…En este sentido, no se encuentra evidencia científica del impacto directo de la pandemia sobre los sistemas de notificación y registro de IS de forma global, aunque hay estudios recientes en ámbitos concretos (AP) 5 , o que de forma parcial estiman este impacto 6 , 7 , 8 . Macías (2021), describió una reducción de las notificaciones entre el 1 de marzo y el 24 de abril de 2020 del 76%, en un centro asistencial (Hospital Universitario Príncipe de Asturias, Comunidad de Madrid, España), de las cuales casi todos los incidentes estaban relacionados con caídas, siendo el personal de enfermería el principal notificador (95%) 9 .…”

Section: Introductionunclassified

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Impacto de la pandemia COVID-19 en los sistemas de notificación de incidentes de seguridad del paciente y errores de medicación

Maroto¹,

González²,

Royo³

et al. 2022

Journal of Healthcare Quality Research

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Patient Safety Incidents in Primary Care: Comparing APEAS–2007 (Spanish Patient Safety Adverse Events Study in Primary Care) with Data from a Health Area in Catalonia (Spain) in 2019

Gens-Barberà,

Astier-Peña,

Hernández-Vidal

et al. 2024

Healthcare

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The initial APEAS study, conducted in June 2007, examined adverse events (AEs) in Spanish Primary Healthcare (PHC). Since then, significant changes have occurred in healthcare systems. To evaluate these changes, a study was conducted in the Camp de Tarragona PHC region (CTPHC) in June 2019. This cross-sectional study aimed to identify AEs in 20 PHC centres in Camp de Tarragona. Data collection used an online questionnaire adapted from APEAS–2007, and a comparative statistical analysis between APEAS–2007 and CTPHC–2019 was performed. The results revealed an increase in nursing notifications and a decrease in notifications from family doctors. Furthermore, fewer AEs were reported overall, particularly in medication-related incidents and healthcare-associated infections, with an increase noted in no-harm incidents. However, AEs related to worsened clinical outcomes, communication issues, care management, and administrative errors increased. Concerning severity, there was a decrease in severe AEs, coupled with an increase in moderate AEs. Despite family doctors perceiving a reduction in medication-related incidents, the overall preventability of AEs remained unchanged. In conclusion, the reporting patterns, nature, and causal factors of AEs in Spanish PHC have evolved over time. While there has been a decrease in medication-related incidents and severe AEs, challenges persist in communication, care management, and clinical outcomes. Although professionals reported reduced severity, the perception of preventability remains an area that requires attention.

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Incidentes de seguridad del paciente notificados antes y después del inicio de la pandemia de COVID-19 en atención primaria en Tarragona

Cited by 3 publications

References 19 publications

Post-pandemic patient safety: Have the characteristics of incidents with harm changed? Comparative observational study in primary care via review of medical records with a trigger tool

Post-pandemic patient safety: Have the characteristics of incidents with harm changed? Comparative observational study in primary care via review of medical records with a trigger tool

Impacto de la pandemia COVID-19 en los sistemas de notificación de incidentes de seguridad del paciente y errores de medicación

Patient Safety Incidents in Primary Care: Comparing APEAS–2007 (Spanish Patient Safety Adverse Events Study in Primary Care) with Data from a Health Area in Catalonia (Spain) in 2019

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