TY - JOUR
T1 - The occurrence of adverse events potentially attributable to nursing care in medical units
T2 - Cross sectional record review
AU - D'Amour, Danielle
AU - Dubois, Carl Ardy
AU - Tchouaket, Éric
AU - Clarke, Sean
AU - Blais, Régis
N1 - Funding Information:
This study was funded by the Canadian Institutes of Health Research and by the Quebec Ministry of Health and Social Services.
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2014/6
Y1 - 2014/6
N2 - Background: Ensuring the safety of hospitalized patients remains a major challenge for healthcare systems, and nursing services are at the center of hospital care. Yet our knowledge about safety of nursing care is quite limited. In fact, most earlier studies examined one, or at most two, indicators, thus presenting an incomplete picture of safety at an institutional or broader level. Furthermore, methodologies have differed from one study to another, making benchmarking difficult. Objectives: The aim of this study was to describe the frequencies of six adverse events widely considered in the literature to be nursing-sensitive outcomes and to estimate the degree to which these events could be attributed to nursing care. Method: Cross-sectional review of charts of 2699 patients hospitalized on 22 medical units in 11 hospitals in Quebec, Canada. The events included: pressure sores, falls, medication administration errors, pneumonias, urinary infections, and inappropriate use of restraints. Experienced nurse reviewers abstracted patients' charts based on a grid developed for the study. Results: Patient-level risk for at least one of these six adverse events was 15.3%, ranging from 9% to 28% across units. Of the 412 patients who experienced an event, 30% experienced two or more, for a total of 568 events. The risk of experiencing an adverse event with consequences was 6.2%, with a unit-level range from 3.2% to 13.5%. Abstractors concluded that 76.8% of the events were attributable to nursing care. Conclusion: While the measurement approach adopted here has limitations stemming from reliance on review of documentation, it provided a practical means of assessing several nursing-sensitive adverse events simultaneously. Given that patient safety issues are so complex, tracking their prevalence and impact is important, as is finding means of evaluating progress in reducing them.
AB - Background: Ensuring the safety of hospitalized patients remains a major challenge for healthcare systems, and nursing services are at the center of hospital care. Yet our knowledge about safety of nursing care is quite limited. In fact, most earlier studies examined one, or at most two, indicators, thus presenting an incomplete picture of safety at an institutional or broader level. Furthermore, methodologies have differed from one study to another, making benchmarking difficult. Objectives: The aim of this study was to describe the frequencies of six adverse events widely considered in the literature to be nursing-sensitive outcomes and to estimate the degree to which these events could be attributed to nursing care. Method: Cross-sectional review of charts of 2699 patients hospitalized on 22 medical units in 11 hospitals in Quebec, Canada. The events included: pressure sores, falls, medication administration errors, pneumonias, urinary infections, and inappropriate use of restraints. Experienced nurse reviewers abstracted patients' charts based on a grid developed for the study. Results: Patient-level risk for at least one of these six adverse events was 15.3%, ranging from 9% to 28% across units. Of the 412 patients who experienced an event, 30% experienced two or more, for a total of 568 events. The risk of experiencing an adverse event with consequences was 6.2%, with a unit-level range from 3.2% to 13.5%. Abstractors concluded that 76.8% of the events were attributable to nursing care. Conclusion: While the measurement approach adopted here has limitations stemming from reliance on review of documentation, it provided a practical means of assessing several nursing-sensitive adverse events simultaneously. Given that patient safety issues are so complex, tracking their prevalence and impact is important, as is finding means of evaluating progress in reducing them.
KW - Adverse events
KW - Falls
KW - Inappropriate use of restraints
KW - Medication administration errors
KW - Nursing-sensitive outcomes
KW - Patient safety
KW - Pneumonia
KW - Pressure sores
KW - Urinary infections
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U2 - 10.1016/j.ijnurstu.2013.10.017
DO - 10.1016/j.ijnurstu.2013.10.017
M3 - Article
C2 - 24238893
AN - SCOPUS:84899636513
SN - 0020-7489
VL - 51
SP - 882
EP - 891
JO - International Journal of Nursing Studies
JF - International Journal of Nursing Studies
IS - 6
ER -