National registry‐based data of adverse events in Finnish long‐term professional homecare in 2009–2019

Abstract

Aims and objectives:The aim of this study was to discover the nature of the adverse events in Finnish long-term professional homecare reported by professionals, and to identify the circumstances in which adverse events occur and their consequences.Background: Adverse events are incidents causing unintended and unnecessary harm to older people at home. Safety is a basic human right and a fundamental prerequisite for independent living among older people at home. Few studies have focused on both long-term professional homecare environment and the safety of older people. Design:The research was a descriptive registry-based study.Methods: This study consisted of adverse events (N = 61248) in Finnish public longterm professional homecare (2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019). Data were described using frequencies and percentages. STROBE statement checklist was chosen for reporting the study process.Results: By profession, practical nurses and registered nurses reported the most of adverse events (89.8%). These were either critical incidents (78.3%) or near misses (20.0%) and concerned medicine, injuries and accidents, information flow or management. Consequences for older people were usually rated from no-harm to moderate harm. For long-term professional homecare, image harm, extra financial costs, noharm and prolonged care for older people were among the consequences. Personnel frequently observed the older people afterwards and informed older people of adverse events, yet some of actions were unknown.Conclusions: Many harmful adverse events are considered harmless for older people.Sometimes this can lead to unmet care needs or missed care. The degree of harm needs to be assessed in terms of physical, mental and social health with the HaiPro reporting system for homecare.Relevance to clinical practice: An understanding and a comprehensive view of the situation and holistic assessment of care needs includes safety and safety risks to increase safety and feeling of safety for older people at home.

Observed Risks of Client Safety by Social Care Professionals in Finland

“…Practical nurses or care workers made most of the reports. This result is congruent with a previous study conducted in the home care context where data were based on the patient safety incident reporting system called HaiPro (Kivimäki et al, 2022). HaiPro and SPro were both developed by an IT company named Awanic (Ltd), and thus have similar structures (Awanic, 2022).…”

“…All reports in the SPro and HaiProsystems are classified as actual or near-miss events, which, in this study, are called observed risks or threats thereof. The proportion of observed risks was greater in this study than that in studies based on the HaiPro-system (Kivimäki et al, 2022). Most of the events occurred in the morning and during the day, whereas in a previous study most patient safety incidents in specialised care settings occurred at night (Kinnunen-Luovi et al, 2014).…”

“…In this study, more than one in ten reported events represented a serious or recurring problem, and approximately 80% caused harm to the client. In the home care context, one-third of reported incidents caused harm to the patient (Kivimäki et al, 2022). In the SPro reports, the harm was most often estimated as moderate, whereas in incident reports from healthcare, the harm is most often mild or no harm (Härkänen et al, 2020).…”