Incidentes de seguridad en urgencias pediátricas: incidencia, características y variabilidad entre centros. Estudio multicéntrico nacional

IF 2.1 4区医学 Q2 PEDIATRICS

Anales de pediatria Pub Date : 2025-10-01 DOI:10.1016/j.anpedi.2025.503998

Dolores Beteta Fernández , Carlos Pérez Cánovas , Rosa Belén Martínez Egea , Julián Alcaraz Martínez , Adriana Catarina De Souza Oliveira , Manuel Pardo Ríos

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引用次数: 0

Abstract

Introduction

Pediatric emergency departments are high-risk environments for patient safety due to the workload, time pressure and clinical vulnerability of the population. However, there is limited evidence regarding the prevalence, characteristics and associated factors of safety incidents in this setting. Understanding these events is essential to design effective improvement strategies.

Objective

To estimate the incidence of patient safety incidents in pediatric emergency departments, describe their characteristics and identify associated factors. Multicenter, observational and descriptive study based on retrospective chart review and structured incident reporting.

Methods

We identified a total of 1102 pediatric patients treated in the emergency departments of nine Spanish hospitals during the second quarter of 2021 were identified. After excluding 49 patients who could not be reached for follow-up, the final sample included 1056 cases. Of these, 90 children experienced incidents related to healthcare, with a total of 94 incidents, as four patients experienced two incidents each. A previously validated tool was used to collect demographic, clinical and organizational data, as well as information on safety incidents.

Results

The overall proportion of patients with at least one safety incident was 8.5% (95%CI: 6.0-9.0). Most incidents caused no harm (39%) or mild to moderate harm (46%), and 13% were deemed clearly preventable. Incidents mainly occurred during emergency care and were attributed to organizational, communication or human factors. There were significant differences between hospitals (P<.01), but we found no associations with shift, triage level, or mode of arrival. The hospital continued to be a significant predictor in the multivariate analysis.

Conclusions

Patient safety incidents in pediatric emergency departments are frequent and partly preventable. The variability observed between centers, which persisted after adjusting for the catchment pediatric population and staffing characteristics, suggests the influence of structural and cultural factors specific to each institution. Context-adapted institutional strategies need to be implemented to foster a proactive safety culture and effective risk management.

Abstract Image

查看原文本刊更多论文

儿科急诊安全事件：发生率、特征和各中心之间的可变性。国家多中心研究

儿科急诊科由于工作量、时间压力和临床易感性，是患者安全的高风险环境。然而，关于这种情况下安全事故的发生率、特征和相关因素的证据有限。了解这些事件对于设计有效的改进策略至关重要。目的估计儿科急诊科患者安全事件的发生率，描述其特征并确定相关因素。基于回顾性图表回顾和结构化事件报告的多中心、观察性和描述性研究。方法：我们确定了2021年第二季度在西班牙9家医院急诊科接受治疗的1102名儿科患者。在排除了49名无法随访的患者后，最终样本包括1056例。其中，90名儿童经历了与医疗保健有关的事件，共有94起事件，其中4名患者每人经历了两次事件。一种先前经过验证的工具用于收集人口统计、临床和组织数据以及安全事故信息。结果至少发生一次安全事件的患者总比例为8.5% （95%CI: 6.0 ~ 9.0）。大多数事件没有造成伤害（39%）或轻度至中度伤害（46%），13%的事件被认为是完全可以预防的。事故主要发生在急救过程中，可归因于组织、沟通或人为因素。医院间有显著差异（P< 0.01），但我们发现与班次、分诊级别或到达方式没有关联。在多变量分析中，医院仍然是一个重要的预测因素。结论儿科急诊科患者安全事故频发，可部分预防。在调整了儿科人口和人员配置特征后，各中心之间观察到的差异仍然存在，这表明每个机构特有的结构和文化因素的影响。需要实施适应环境的制度战略，以培养积极主动的安全文化和有效的风险管理。

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

Anales de pediatria 医学-小儿科

CiteScore

2.10

自引率

4.80%

发文量

155

审稿时长

44 days

期刊介绍： La Asociación Española de Pediatría tiene como uno de sus objetivos principales la difusión de información científica rigurosa y actualizada sobre las distintas áreas de la pediatría. Anales de Pediatría es el Órgano de Expresión Científica de la Asociación y constituye el vehículo a través del cual se comunican los asociados. Publica trabajos originales sobre investigación clínica en pediatría procedentes de España y países latinoamericanos, así como artículos de revisión elaborados por los mejores profesionales de cada especialidad, las comunicaciones del congreso anual y los libros de actas de la Asociación, y guías de actuación elaboradas por las diferentes Sociedades/Secciones Especializadas integradas en la Asociación Española de Pediatría.