The Incidence and Nature of Adverse Events During Inpatient Rehabilitation: A Retrospective Case Series.

IF 2.2 4区医学 Q1 REHABILITATION

American Journal of Physical Medicine & Rehabilitation Pub Date : 2024-08-26 DOI:10.1097/PHM.0000000000002614

Shangge Jiang, Dalia Othman, Laura Kathleen Langer, Mark Bayley, Christian Fortin, Amanda Mayo, Jordan Pelc, Lawrence R Robinson, Christine Soong, Meiqi Guo

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引用次数: 0

Abstract

Objective: To describe and compare adverse event (AE) incidence, type, severity, and preventability in the Canadian inpatient rehabilitation setting.

Design: In this retrospective case series, AEs were identified through chart reviews from two Canadian academic tertiary post-acute care hospitals. AEs were characterized through descriptive statistics and compared using the Mantel-Haenszel and Fisher's exact tests.

Results: During the study period, one site (n = 120) had 28 AEs and an incidence of 9.7 (95% CI 6.1-13.3) per 1000 patient days, and the other (n = 48) had 15 AEs and an incidence of 13.9 (95% CI 6.9-21) per 1000 patient days (p = 0.82). The two sites differed significantly in AE type (p = 0.033) and preventability (p = 0.002) but not severity. The most common AE type was medication/intravenous fluids-related (16/28, 57%) at one site and patient incidents (e.g., falls, pressure ulcers) at the other. Four percent (1/28) of AEs were preventable at one site, and 53% (8/15) at another. Most AEs at both sites were mild in severity.

Conclusions: AEs significantly differed in type and preventability between the two sites. These results suggest the importance of context and the need for an organization-specific and tailored approach when addressing patient safety in inpatient rehabilitation settings.

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住院康复期间不良事件的发生率和性质：回顾性病例系列。

目的描述并比较加拿大住院康复环境中不良事件（AE）的发生率、类型、严重程度和可预防性：在这项回顾性病例系列研究中，通过对加拿大两家学术性三级康复后护理医院的病历进行审查，确定了不良事件。通过描述性统计对AE进行特征描述，并使用曼特尔-海恩泽尔检验和费雪精确检验对AE进行比较：在研究期间，一家医院（n = 120）发生了 28 例 AE，发生率为每 1000 个患者日 9.7 例（95% CI 6.1-13.3）；另一家医院（n = 48）发生了 15 例 AE，发生率为每 1000 个患者日 13.9 例（95% CI 6.9-21）（p = 0.82）。两地在 AE 类型（p = 0.033）和可预防性（p = 0.002）方面存在显著差异，但在严重程度方面没有差异。最常见的 AE 类型是药物/静脉输液相关（16/28，57%）和患者事故（如跌倒、压疮）。在一家医疗机构，4%（1/28）的 AE 是可预防的，而在另一家医疗机构，53%（8/15）的 AE 是可预防的。两地的大多数 AE 严重程度都较轻：结论：两地的 AE 在类型和可预防性方面存在明显差异。这些结果表明，在解决住院康复机构的患者安全问题时，环境非常重要，需要采取针对具体机构的定制方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Physical Medicine & Rehabilitation 医学-康复医学

CiteScore

4.60

自引率

6.70%

发文量

423

审稿时长

1 months

期刊介绍： American Journal of Physical Medicine & Rehabilitation focuses on the practice, research and educational aspects of physical medicine and rehabilitation. Monthly issues keep physiatrists up-to-date on the optimal functional restoration of patients with disabilities, physical treatment of neuromuscular impairments, the development of new rehabilitative technologies, and the use of electrodiagnostic studies. The Journal publishes cutting-edge basic and clinical research, clinical case reports and in-depth topical reviews of interest to rehabilitation professionals. Topics include prevention, diagnosis, treatment, and rehabilitation of musculoskeletal conditions, brain injury, spinal cord injury, cardiopulmonary disease, trauma, acute and chronic pain, amputation, prosthetics and orthotics, mobility, gait, and pediatrics as well as areas related to education and administration. Other important areas of interest include cancer rehabilitation, aging, and exercise. The Journal has recently published a series of articles on the topic of outcomes research. This well-established journal is the official scholarly publication of the Association of Academic Physiatrists (AAP).