scholarly journals Patient Safety in Pediatrics

2020 ◽  
pp. 299-308
Author(s):  
Sara Albolino ◽  
Marco De Luca ◽  
Antonino Morabito
Keyword(s):  
Patient Safety ◽  
Adverse Events ◽  
Health System ◽  
Pediatric Patient ◽  
Medication Errors ◽  
Surgical Complications ◽  
Hospitalized Children ◽  
Intravenous Line ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

AbstractSince the publication of the 1999 IOM report “To Err Is Human: Building a Safer Health System,” much has been learned about pediatric patient safety. However, adverse events still affect one-third of all hospitalized children [1]. The main areas of adverse events are hospital-acquired infections, intravenous line complications, surgical complications, and medication errors [2].

scholarly journals Global Trigger Tool methodology to detect adverse events: pilot study at Academic Hospital of Udine

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Scarpis ◽  
S Degan ◽  
D De Corti ◽  
F Mellace ◽  
R Cocconi ◽  
...  
Keyword(s):  
Patient Safety ◽  
Adverse Events ◽  
Academic Hospital ◽  
Trigger Tool ◽  
Hospital Acquired Infections ◽  
Frequent Type ◽  
Global Trigger Tool ◽  
Clinical Records ◽  
Hospital Acquired ◽  
Over Time

Abstract Introduction Identification and measurement of adverse events (AEs) is crucial for patient safety in order to monitor them over time and to implement quality improvement programs, testing if they are effective. Global Trigger Tool (GTT) has been proposed as a low-cost method, being also the most effective to detect AEs. This study aims to describe the number of triggers, the rate and level of AEs identified by GTT and the most frequent type of AE. Methods The Italian version of the GTT was used. Ten paper-based clinical records (CRs) randomly selected every 2 weeks were reviewed from January to April 2019 by three independent reviewers (two nurses, one doctor) at the Academic Hospital of Udine. The AEs rates calculated are: AEs per 1,000 patient-days, AEs per 100 admissions, percentage of admissions with an AE. AEs were classified by harm levels according to National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP). Results CRs reviewed were 80. Mean age of the patients was 69.3±16.4, women were 37.5%. Mean hospitalisation was 16.8±15.3. Nine were the cases of re-hospitalisation within 30 days (11.3%). The total number of trigger was 156. AEs were 31, with at least one AE on 27.5% of admissions, 38.8 AEs per 100 admissions and 23 AEs per 1,000 patient-days. AEs with harm level E, F and H were respectively 5 (16.1%), 24 (77.4%) and 2 (6.5%). The most frequent type of AE were hospital acquired infections with 15 cases (48.4%). Conclusions The most frequent type of AE was the hospital acquired infections. Rates and levels of AEs were higher than other international studies, probably because of the limited number of CRs reviewed. Key messages Global Trigger Tool is an effective method to detect adverse patient safety events in order to monitor them over time. The most frequent type of adverse events was the hospital acquired infections.

scholarly journals Reducing hospital-acquired infections in a regional health system

2021 ◽  
pp. 1-2
Author(s):  
Keith L. Grant ◽  
Dora E. Wiskirchen ◽  
Ulysses Wu ◽  
Michael R. Grey ◽  
Pracha P. Eamranond
Keyword(s):  
Health System ◽  
Regional Health ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

scholarly journals Eventos adversos en niños hospitalizados: un desafío para el cuidado de enfermería

2019 ◽  
pp. 111-123
Author(s):  
Cielo Rebeca Martínez Reyes ◽  
Fayzuri Álvarez Reyes ◽  
Cesar Augusto Garzón Martínez ◽  
Isabel Cristina Rave Henao
Keyword(s):  
Patient Safety ◽  
Adverse Events ◽  
Nursing Care ◽  
Safety Culture ◽  
Pressure Ulcers ◽  
Institutional Environment ◽  
Scientific Evidence ◽  
Hospitalized Children ◽  
Data Bases ◽  
Palabras Clave

Introducción: La enfermería, profesión con raíces humanistas, preocupada por las personas que confían en su cuidado, tiene como desafío garantizar la seguridad de los pacientes, incluidos los niños. Metodología: Se realizó una revisión de artículos científicos publicados entre 2010 y 2017, en las bases de datos NCBI, Lilacs, Redalyc, Scielo, Elsevier, Medigraphic, Google Académico y Science Direct; escritos en español, inglés y portugués que cumplían con criterios de pertinencia metodológica y temática.  Las palabras clave empleadas fueron: eventos adversos, enfermería pediátrica y seguridad del paciente. Los artículos fueron evaluados con las escalas Prisma, Strobe y Coreq. Resultados: Se seleccionaron 14 artículos que analizaban eventos adversos propios del cuidado de enfermería en niños hospitalizados relacionados con:  medicamentos, infecciones, flebitis y úlceras por presión, en los cuales se concluía que factores propios del infante, los dispositivos utilizados, el ambiente institucional y el actuar del personal, pueden incidir en la ocurrencia de errores que deterioran la salud del niño. Conclusiones: Apropiarse de una cultura de seguridad que incluya la adherencia a protocolos y la reafirmación de conocimientos sobre prácticas seguras, basadas en la mejor evidencia científica, son estrategias infalibles en la mitigación y prevención de los eventos adversos en el cuidado de enfermería.   Palabras clave: Cuidado de enfermería, eventos adversos, niños hospitalizados, seguridad del paciente.   Adverse events in hospitalized children: a challenge for Nursing Care Abstract Introduction: Nursing, a profession with humanist roots, concerns about people who trust in its care, and has the challenge of guaranteeing the patients safety, including children. Methodology: A review was performed on scientific articles published between 2010 and 2017, from the data bases NCBI, Lilacs, Redalyc, Scielo, Elsevier, Medigraphic, Google Scholar and Science Direct; written in Spanish, English and Portuguese and met the pertinent methodological and subject criteria. The keywords employed were: adverse events, pediatric nursing and patient safety. The articles were evaluated with the PRISMA, STROBE and COREQ guidelines. Results: 14 articles were selected, these analyzed adverse events proper of nursing care in hospitalized children related to: medication, infections, phlebitis and pressure ulcers, concluding that factors specific to the infant, used devices, institutional environment and personnel performance incites the occurrence of errors that deteriorate the health of the child. Conclusions: Appropriating a safety culture that includes the adherence to protocols and the reaffirmation of knowledge about safe practices based on the best scientific evidence, are infallible strategies in the mitigation and prevention of adverse events in nursing care. Keywords: Nursing care, adverse events, hospitalized children, patient safety.   Eventos adversos em crianças hospitalizadas: um desafio para o Cuidado de Enfermagem Resumo Introdução: A enfermagem, profissão com raízes humanistas, preocupada pelas pessoas que confiam em seu cuidado, tem como desafio garantir a segurança dos pacientes, incluídas as crianças. Metodologia: Realizou-se uma revisão de artigos científicos publicados entre 2010 e 2017, nas bases de dados NCBI, Lilacs, Redalyc, Scielo, Elsevier, Medigraphic, Google Acadêmico e Science Direct; escrito em espanhol, inglês e português que preencheram critérios de relevância metodológica e temática.  As palavras chave empregadas foram: eventos adversos, enfermagem pediátrica e segurança do paciente. Os artigos foram avaliados com as escalas Prisma, Strobe e Coreq. Resultados: Foram selecionados 14 artigos que analisavam eventos adversos próprios do cuidado de enfermagem em crianças hospitalizadas relacionados com:  medicações, infecções, flebites e úlceras por pressão, nos quais se concluía que fatores próprios do bebê, os dispositivos utilizados, o ambiente institucional, o agir do pessoal, podem incidir na ocorrência de erros que deterioram a saúde da criança. Conclusões: Criar uma cultura de segurança que inclua a aderência a protocolos e a reafirmação de conhecimentos sobre práticas seguras, baseadas na melhor evidência científica, são estratégias infalíveis na mitigação e prevenção dos eventos adversos no cuidado de enfermagem. Palavras-chave: Cuidado de enfermagem, eventos adversos, crianças hospitalizadas, segurança do paciente.

scholarly journals Financial Incentives to Reduce Hospital-Acquired Infections Under Alternative Payment Arrangements

2018 ◽  
Vol 39 (5) ◽  
pp. 509-515 ◽  
Author(s):  
Catherine Crawford Cohen ◽  
Jianfang Liu ◽  
Bevin Cohen ◽  
Elaine L. Larson ◽  
Sherry Glied
Keyword(s):  
Patient Safety ◽  
Financial Incentives ◽  
Improve Patient Safety ◽  
Tertiary Care ◽  
Hospital Costs ◽  
Urban Hospital ◽  
Hospital System ◽  
Hospital Acquired Infections ◽  
Tract Infections ◽  
Hospital Acquired

OBJECTIVEThe financial incentives for hospitals to improve care may be weaker if higher insurer payments for adverse conditions offset a portion of hospital costs. The purpose of this study was to simulate incentives for reducing hospital-acquired infections under various payment configurations by Medicare, Medicaid, and private payers.DESIGNMatched case-control study.SETTINGA large, urban hospital system with 1 community hospital and 2 tertiary-care hospitals.PATIENTSAll patients discharged in 2013 and 2014.METHODSUsing electronic hospital records, we identified hospital-acquired bloodstream infections (BSIs) and urinary tract infections (UTIs) with a validated algorithm. We assessed excess hospital costs, length of stay, and payments due to infection, and we compared them to those of uninfected patients matched by propensity for infection.RESULTSIn most scenarios, hospitals recovered only a portion of excess HAI costs through increased payments. Patients with UTIs incurred incremental costs of $6,238 (P<.01), while payments increased $1,901 (P<.05) at public diagnosis-related group (DRG) rates. For BSIs, incremental costs were $15,367 (P<.01), while payments increased $7,895 (P<.01). If private payers reimbursed a 200% markup over Medicare DRG rates, hospitals recovered 55% of costs from BSI and UTI among private-pay patients and 54% for BSI and 33% for UTI, respectively, across all patients. Under per-diem payment for private patients with no markup, hospitals recovered 71% of excess costs of BSI and 88% for UTI. At 150% markup and per-diem payments, hospitals profited.CONCLUSIONSHospital incentives for investing in patient safety vary by payer and payment configuration. Higher payments provide resources to improve patient safety, but current payment structures may also reduce the willingness of hospitals to invest in patient safety.Infect Control Hosp Epidemiol 2018;39:509–515

scholarly journals Room Sharing in Hospitalized Children With Bronchiolitis and the Occurrence of Hospital-Acquired Infections: A Prospective Cohort Study

2019 ◽  
Vol 9 (6) ◽  
pp. 415-422 ◽  
Author(s):  
Jolita Bekhof ◽  
Mirjam Wessels ◽  
Eline ten Velde ◽  
Minke Hoekstra ◽  
Veerle Langenhorst ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Hospitalized Children ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

Medication Errors in Family Practice, in Hospitals and after Discharge from the Hospital: An Ethical Analysis

2004 ◽  
Vol 32 (2) ◽  
pp. 349-357 ◽  
Author(s):  
Peter A. Clark
Keyword(s):  
Patient Safety ◽  
Health System ◽  
Vietnam War ◽  
Medication Errors ◽  
Family Practice ◽  
Medical Errors ◽  
Ethical Analysis ◽  
Institute Of Medicine ◽  
Surgery Patient

The issue of death due to medical errors is not new. We have all heard horror stories about patients dying in the hospital because of a drug mix-up or a surgery patient having the wrong limb amputated. Most people believed these stories were the exception to the rule until November 1999, when the Institute of Medicine (IOM) issued a report entitled To Err Is Human: Building A Safer Health System. This report focused on medical errors and patient safety in U.S. hospitals. The report indicated that as many as 44,000 to 98,000 people die each year in hospitals as a result of medical errors. These numbers suggest that more Americans are killed in U.S.hospitals every 6 months than died in the entire Vietnam War, and some have compared the alleged rate to fully loaded jumbo jets crashing every other day. This report was not without its critics.

scholarly journals Physical Plant Design and Engineering Controls to Reduce Hospital-Acquired Infections

2006 ◽  
Vol 17 (3) ◽  
pp. 151-153
Author(s):  
JM Conly ◽  
BL Johnston
Keyword(s):  
Patient Safety ◽  
Disease Transmission ◽  
Hospital Setting ◽  
Hospital Environment ◽  
Robert Wood Johnson Foundation ◽  
Plant Design ◽  
Design Standards ◽  
Hospital Acquired Infections ◽  
Physical Plant ◽  
Hospital Acquired

The importance of the environment as a reservoir for microorganisms implicated in disease transmission in the hospital setting has been increasingly recognized, especially with respect to dialysis units, ventilation in specialized areas, and the proper use of disinfectants (1). Inherent within the environmental setting is the importance of physical plant design. Several studies have underscored the importance of optimizing design standards to maximize patient and health care worker (HCW) safety, including the prevention of hospital-acquired infections in patients (2-6). Ulrich et al (7) recently completed an evidence-based review, entitled'The role of the physical environment in the hospital of the 21st century: A once-in-a-lifetime opportunity', for the Center for Health Design in California (USA), which was funded by the Robert Wood Johnson Foundation. Ulrich and colleagues identified over 600 studies that examined the hospital environment and its effects on staff effectiveness, patient safety, patient and family stress, quality and costs. They suggested that one of the important elements in improving patient safety is the reduction of the risk of hospital-acquired infections through improved facility design.

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