The incidence of adverse events among home care patients

Sears, Nancy; Baker, G. Ross; Barnsley, Jan; Shortt, Sam

doi:10.1093/intqhc/mzs075

Cited by 79 publications

(116 citation statements)

References 33 publications

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“…Because safety incidents in Iranian hospitals have not been well documented, the authors had to use previously related researches as a proper estimation for nursing-related patient safety incidents. Nursing-related patient safety incidents have been pointed out in many international investigations and their reliability and validity have been proved and reported (9,10,21,(27)(28)(29).…”

Section: Patient Adverse Outcomesmentioning

confidence: 99%

The Association of Nursing Workloads, Organizational, and Individual Factors with Adverse Patient Outcome

Abadi¹,

Akbari²,

Akbari³

et al. 2016

Iran Red Crescent Med J

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Introduction: Adverse patient outcomes have become a big concern in the quality of healthcare. Different factors can have an impact on the variety and rate of adverse patient outcomes. Objectives: The present study aimed at determining the rate of patient safety during events and evaluating nursing workloads as well as identifying the main factors that affect the incidence rate of patient safety events among nurses. Methods: This cross-sectional study was conducted on 293 nurses working in 24 wards of Baqiyatallah hospital in Tehran, Iran, in 2016. The sampling method was stratified random sampling. Data were collected using a self-administered questionnaire, which was classified into 4 subtitles: Individual and organizational characteristics, perceived subjective, objective workloads, and some patient safety events during the past 6 months. Binary and multiple regressions were used to survey the relationship between variables using the SPSS Version 23 software. Results: Bloodstream infection, pressure ulcer, and patient falls were the most reported adverse outcomes during the past 6 months with 76.1%, 66.2%, and 59%, respectively. At least one of the 6 adverse outcomes was reported by nurses within the range of 45%-77%. Of all individual characteristics, the only significant relationship occurred between work experience and bloodstream infection (P value = 0.28 and 0.32). No significant relationship was detected between adverse patient outcomes and objective workloads. Regression models revealed that the subjective workload of adverse patient outcomes increased with making adjustments in the individual and organizational characteristics. The incidence rates of adverse outcomes were 5.69-9.78 times more than the fixed shifts in all rotational shift works. Conclusions: The nurses reported a high incidence rate of all patient safety events, and the results revealed that the objective workload could not be a predictor for patient adverse events. According to the findings, subjective workload and work shift were significantly related to the incidence rate of adverse patient events. In conclusion, good regulation of sleep-wake cycles can be an important factor for decreasing the rate of adverse patient events.

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Section: Patient Adverse Outcomesmentioning

confidence: 99%

The Association of Nursing Workloads, Organizational, and Individual Factors with Adverse Patient Outcome

Abadi¹,

Akbari²,

Akbari³

et al. 2016

Iran Red Crescent Med J

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“…However, only a few studies have used a similar approach to safety issues among home care (HC) clients. The studies of HC clients are limited with regard to small sample size6 7 population studied (eg, long-stay clients)7 8 and types of harm (eg, when only physical harm is examined) 6…”

Section: Introductionmentioning

confidence: 99%

Assessing adverse events among home care clients in three Canadian provinces using chart review

et al. 2013

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ObjectivesThe objectives of this study were to document the incidence rate and types of adverse events (AEs) among home care (HC) clients in Canada; identify factors contributing to these AEs; and determine to what extent evidence of completion of incident reports were documented in charts where AEs were found.MethodsThis was a retrospective cohort study based on expert chart review of a random sample of 1200 charts of clients discharged in fiscal year 2009–2010 from publicly funded HC programmes in Manitoba, Quebec and Nova Scotia, Canada.ResultsThe results show that 4.2% (95% CI 3.0% to 5.4%) of HC patients discharged in a 12-month period experienced an AE. Adjusting to account for clients with lengths of stay in HC of less than 1 year, the AE incidence rate per client-year was 10.1% (95% CI 8.4% to 11.8%); 56% of AEs were judged preventable. The most frequent AEs were injuries from falls, wound infections, psychosocial, behavioural or mental health problems and adverse outcomes from medication errors. More comorbid conditions (OR 1.15; 95% CI 1.05 to 1.26) and a lower instrumental activities of daily living score (OR 1.54; 95% CI 1.16 to 2.04) were associated with a higher risk of experiencing an AE. Clients’ decisions or actions contributed to 48.4% of AEs, informal caregivers 20.4% of AEs, and healthcare personnel 46.2% of AEs. Only 17.3% of charts with an AE contained documentation that indicated an incident report was completed, while 4.8% of charts without an AE had such documentation.ConclusionsClient safety is an important issue in HC, as it is in institutionalised care. HC includes the planned delivery of self-care by clients and care provision by family, friends and other individuals often described as ‘informal’ caregivers. As clients and these caregivers can contribute to the occurrence of AEs, their involvement in the delivery of healthcare interventions at home must be considered when planning strategies to improve HC safety.

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“…(24,25) Yet the rise of homecare for children with complex medical needs has not been accompanied by a parallel rise in the recognition of these risks, nor in the development of strategies to mitigate them. (26)(27)(28)(29) How best families and children can be supported in in preventing and controlling infection in the community remains poorly understood…”

Section: Increasing Numbers Of Children With Invasive Devices Living mentioning

confidence: 99%

What is the right approach to infection prevention and control for children living at home with invasive devices?

Soto

Tarrant

Dixon‐Woods

2016

Journal of Hospital Infection

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The incidence of adverse events among home care patients

Cited by 79 publications

References 33 publications

The Association of Nursing Workloads, Organizational, and Individual Factors with Adverse Patient Outcome

The Association of Nursing Workloads, Organizational, and Individual Factors with Adverse Patient Outcome

Assessing adverse events among home care clients in three Canadian provinces using chart review

What is the right approach to infection prevention and control for children living at home with invasive devices?

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