Effect of patient safety strategies on the incidence of adverse events

• Published in: Journal of evaluation in clinical practice Vol. 20; no. 2; pp. 184 - 190
• Main Authors: Fernandez Sierra, M. Amelia, Rodriguez del Aguila, M. del Mar, Navarro Espigares, Jose Luis, Enriquez Maroto, M. Francisca
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.04.2014
• Subjects: adverse events; Age Factors; Aged; Aged, 80 and over; avoidable effects; Communication; comparative-effectiveness research; Documentation; Female; hospital; Humans; Incidence; Length of Stay; Male; Middle Aged; Patient Safety; Quality of Health Care - organization & administration; Risk Factors; Spain; avoidable effects; patient safety; comparative-effectiveness research; adverse events; hospital
• ISSN: 1356-1294; 1365-2753
• DOI: 10.1111/jep.12105

Objective This study aims to estimate the incidence of adverse events (AEs) and avoidable AE in four hospital services before and after applying strategies for patient safety. Design Retrospective study of two cohorts (2006 and 2009). Setting General Surgery, Internal Medicine, Intensive Care Unit and Oncology services. Participants A sample of 365 patients (2006) and 232 in 2009 randomly selected from the services previously cited. Interventions Strategies to improve patient safety (e.g. hand‐hygiene campaign). Main outcome measures Analyses were made of the change in the incidence and type of AE and avoidable AE, number of procedures and additional days of hospital stay, and the concordance between two recording systems. Results The incidence of patients with AE was 20.8% in 2006 compared with 28.9% in 2009 (P < 0.05). Oncology had twofold more AE than did General Surgery [odds ratio (OR) = 2.07, 95% confidence interval (CI): 1.12–3.86] for the same length of stay and number of extrinsic risk factors. In 2006, 84.6% were considered avoidable, compared with 57.1% of 2009 (P < 0.001). There was no difference in the average length of additional stay. In 2006, there were more additional procedures compared to 2009 (OR = 2.75, 95% CI: 1.28–6.06). A concordance of 61% was found for the detection of AE with the two recording systems. Conclusions An increased incidence in AEs was found after the strategies, while avoidable AE decreased, as did additional treatments and procedures. The measures implemented constitute a further step in reducing avoidance and a greater awareness of recording AEs in the discharge report.