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The incidence of adverse events among home care patients.
MedLine Citation:
PMID:  23283731     Owner:  NLM     Status:  Publisher    
OBJECTIVE: /st>Incidence of adverse events (AEs) among home care patients and preventability ratings were estimated. Risk factors, AE types and factors associated with AEs were identified. DESIGN: /st>This study used a stratified, randomized sample of home care patients discharged in the fiscal year 2004/05. Trained nurse reviewers completed retrospective chart abstractions; charts for cases that were positive for screening criteria suggesting the presence of AEs were reviewed by trained physicians to determine the presence of and preventability of AEs. SETTING: /st>Three publicly funded home care programs in Ontario, Canada. MAIN OUTCOME MEASURES: /st>Prevalence and types of AEs; ratings of preventability. RESULTS: /st>At least one screening criterion was positively identified in 286 (66.5%) of 430 cases. Physician reviewers identified 61 AEs in 55 (19.2%) of the 286 (12.8% of the 430) cases. The AE rate was 13.2 per 100 home care cases [95% confidence interval (CI): 10.4-16.6%, standard error 1.6%]. 32.7% (20 of 61 AEs) of the AEs were rated as having >50% probability of preventability; 6 deaths (10.9% of patients with an AE; 1.4% of all patients) occurred in AE-positive patients. The most common AEs were falls and adverse drug events. CONCLUSIONS: /st>Providing health care through home care programs creates unintended harm to patients. The incidence rate of AEs of 13.2% suggests a significant number of home care patients experience AEs, one-third of which were considered preventable. Improvements in patient and informal caregiver education, skill development and clinical planning may be useful interventions to reduce AEs.
Nancy Sears; G Ross Baker; Jan Barnsley; Sam Shortt
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-2
Journal Detail:
Title:  International journal for quality in health care : journal of the International Society for Quality in Health Care / ISQua     Volume:  -     ISSN:  1464-3677     ISO Abbreviation:  Int J Qual Health Care     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9434628     Medline TA:  Int J Qual Health Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1Department of Health Sciences, St. Lawrence College, 100 Portsmouth Avenue, Kingston, ON, Canada K7L 5A6.
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