THE FREQUENCY OF ADVERSE EVENTS AMONG PEDIATRIC INPATIENTS IN THE MATERNITY AND CHILDREN TEACHING HOSPITAL IN AL-DIWANIYAH
DOI:
https://doi.org/10.61841/k49rhr78Keywords:
Arousal fluid, Vagina cancer, cervical cancer, Slide, Home procedureAbstract
An important indicator of the pediatric patient safety is the rate of adverse events (AEs) among in-hospital pediatric patients. AEs are an important cause of morbidity and mortality for pediatric inpatients.
Population and methods-A prospective study was performed on admissions to the Maternity and Pediatrics Teaching Hospital in Al-Diwaniyah( Iraq, 180 km south of Baghdad) from January 1st to June 30th, 2019. All patients were followed-up to document the duration of hospitalization, and the degree of harm at discharge. Daily visits to all wards were carried out for recording demographic information and duration of hospitalization, history of chronic conditions, and excluding those out of this study. A total of 3772 were admissions to the hospital during the study period. Data were spread into worksheet of Microsoft Office Excel 2016 for subsequent analysis.
Results-In this study, a 356 (9.4 %) from 3772 patients found to have AEs. AEs occurred in 16 (4.5 %) patients admitted for up to 5 days, 122 (34.3%) patients admitted for 6 - 10 days, and 218 (61.2 %) patients admitted for > 10 days (p value = 0.001, significant). Neonates, whether admitted to neonatal intensive care unit or nursery care unit, were more commonly afflicted by AEs. AEs occurred in 115 (32.3 %) out of 356 patients with AEs (p value = 0.008).Another statistically significant value (p value = 0.001) was found in the distribution of AEs among patients of specific wards, namely neona tal intensive care unit (NICU), nursery care unit (NCU), PICU, isolationward, and surgicalward. AEs occurred in 41 (11.5 %) patients in neonatal intensive care unit, 67 (18.8%) patients in nursery care unit, 15 (4.2 %) patients in pediatric intensive care unit, 23 (6.5 %) patients in isolation ward, and 35 (9.8 %) patients in surgical ward. No other level of significance was found regarding distribution of adverse events according to sex, residence, provisional diagnosis, and past medical history. Four classes of patients with AEs were identified as a result of the degree of harm: 205 (57.6 %) patients who
required just intervention, 135 (37.9 %) patients who required intervention with prolonged hospital stay,
5 (1.4 %) patients with disability at time of discharge, and 11 (3.1 %) patients who died from AE. Conclusion-The rate of AEs from provision of medical care in our hospital was high and did not seem to be different from that in other studies around the world. AEs incidence rate was common in neonates admitted either to neonatal intensive care unit or to nursery care unit, in patients with longer duration of hospitalization, and in patients from pediatric intensive care unit, and isolation and surgical wards.
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References
1. Institute of Medicine, Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press; 2001
2. Kohn LT, Corrigan JM, Donaldson MS, eds. To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Press; 2000
3. Aspden P, Corrigan J, Wolcott J, et al, eds; Institute of Medicine, Committee on Data Standards for Patient
Safety. Patient Safety: Achieving a New Standard for Care. Washington, DC: National Academies Press; 2004
4. Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, Lawthers AG, et al. Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. N Engl J Med 1991;324(6):370-7.
5. Wilson RM, Runciman WB, Gibberd RW, Harrison BT, Newby L, Hamilton JD. The Quality in Australian Health Care Study. Med J Aust 1995;163 (9):458-76.
6. Leape LL, Brennan TA, Laird N, Lawthers AG, Localio AR, Barnes BA, et al. The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II. N Engl J Med 1991;324(6):377-84.
7. Thomas EJ, Studdert DM, Burstin HR, Orav EJ, Zeena T, Williams EJ, et al. Incidence and types of adverse events and negligent care in Utah and Colorado. Med Care 2000;38(3):261-71.
8. Davis P, Lay-Yee R, Briant R, Schug S, Scott A, Johnson S, et al. Adverse events in New Zealand public hospitals: principal findings from a national survey. Wellington: NZ Ministry of Health; 2001. Occasional Paper no 3. Available: www.moh.govt.nz/publications/adverseevents (accessed 2004 Apr 28).
9. Vincent C, Neale G, Woloshynowych M. Adverse events in British hospitals: preliminary retrospective record review [published erratum in BMJ 2001;322:1395]. BMJ 2001;322(7285):517-9.
10. Dakhil, A.S.Assessment of novel cardiovascular biomarkers in patients with chronic heart failures. Inter J Res Pharm Sci 2019; 10(4):3728-3732.
11. Dakhil, A.S.Association of the atp-binding cassette transporter a1 gene polymorphism with lipid profile and type 2 diabetes mellitus. Res J Phar Tech 2019; 12(10): 4657-4662.
12. Dakhil, A.S.Association of the ATP-binding cassette transporter a1 gene polymorphism with lipid profile and type 2 diabetes mellitus. Prensa Med Argent 2019; 105(5):284-292.
13. Thomas E, Brennan T. Errors and adverse events in medicine. In: Vincent C, editor. Clinical risk management: enhancing patient safety. London: BMJ Publications; 2001.
14. Wu AW. Medical error: the second victim. The doctor who makes the mistake needs help too. BMJ. 2000;320(7237):726–727
15. Stockwell DC, Landrigan CP, Toomey SL, et al; GAPPS Study Group. Adverse events in hospitalized pediatric patients. Pediatrics. 2018;142(2):e20173360
16. Khan A, Furtak SL, Melvin P, Rogers JE, Schuster MA, Landrigan CP. Parent-reported errors and adverse events in hospitalized children. JAMA Pediatr. 2016;170(4):e154608
17. Matlow AG, Cronin CM, Flintoft V, et al. Description of the development and validation of the Canadian Paediatric Trigger Tool. BMJ Qual Saf 2011;20(5):416-23.
18. Otero P, Leyton A, Mariani G, et al. Medication errors in pediatric inpatients: prevalence and results of a prevention program. Pediatrics 2008;122(3):e737-43.
19. 19.Classen DC, Resar R, Griffi n F, et al. ‘Global trigger tool’ shows that adverse events in hospitals may be ten times greater than previously measured. Health Aff (Millwood). 2011;30(4):581–589
20. Kirkendall ES, Kloppenborg E, Papp J, et al. Measuring adverse events and levels of harm in pediatric inpatients with the Global Trigger Tool. Pediatrics 2012;130(5):e1206-14.
21. Thomas EJ, Studdert DM, Runciman WB, Webb RK, Sexton EJ, Wilson RM, et al. A comparison of iatrogenic injury studies in Australia and the USA. I: Context, methods, casemix, population, patient and hospital characteristics. International journal for quality in health care : journal of the International Society for Quality in Health Care / ISQua. 2000;12(5):371-8. Epub 2000/11/18.
22. Runciman WB, Webb RK, Helps SC, Thomas EJ, Sexton EJ, Studdert DM, et al. A comparison of iatrogenic injury studies in Australia and the USA. II: Reviewer behaviour and quality of care. International journal for quality in health care : journal of the International Society for Quality in Health Care / ISQua. 2000;12(5):379-88. Epub 2000/11/18.
23. Michel P, Quenon JL, Djihoud A et al. French national survey of inpatient adverse events prospectively assessed with ward staff. Qual Saf Health Care 2007;16:369–77.
24. Annual record of the Maternity and Children Teaching Hospital of the year 2018.
25. Matlow AG, Baker GR, Flintoft V, et al. Adverse events among children in Canadian hospitals: the Canadian Paediatric Adverse Events Study. CMAJ. 2012;184(13):E709–E718
26. Woods D, Thomas E, Holl J, Altman S, Brennan T. Adverse events and preventable adverse events in children. Pediatrics. 2005;115(1):155–160.
27. Härkänen M, Kervinen M, Ahonen J, et al. Patient-specific risk factors of adverse drug events in adult inpatients-evidence detected using the Global Trigger Tool method. J Clin Nurs 2015;24(3-4):582-91.
28. Najjar S, Hamdan M, Euwema MC, et al. The Global Trigger Tool shows that one out of seven patients suffers harm in Palestinian hospitals: challenges for launching a strategic safety plan. Int J Qual Health Care 2013;25(6):640-7.
29. Sharek PJ, Horbar JD, Mason W, et al. Adverse events in the neonatal intensive care unit: development, testing, and findings of an NICU focused trigger tool to identify harm in North American NICUs. Pediatrics. 2006;118(4):1332–1340
30. Agarwal S, Classen D, Larsen G, et al. Prevalence of adverse events in pediatric intensive care units in the United States. PediatrCrit Care Med. 2010;11(5):568–578.
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