Dolores Beteta Fernández , Carlos Pérez Cánovas , Rosa Belén Martínez Egea , Julián Alcaraz Martínez , Adriana Catarina De Souza Oliveira , Manuel Pardo Ríos
{"title":"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","authors":"Dolores Beteta Fernández , Carlos Pérez Cánovas , Rosa Belén Martínez Egea , Julián Alcaraz Martínez , Adriana Catarina De Souza Oliveira , Manuel Pardo Ríos","doi":"10.1016/j.anpedi.2025.503998","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>The overall proportion of patients with at least one safety incident was 8.5% (95%<span>C</span>I: 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 (<em>P</em><.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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"103 4","pages":"Article 503998"},"PeriodicalIF":2.1000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Incidentes de seguridad en urgencias pediátricas: incidencia, características y variabilidad entre centros. Estudio multicéntrico nacional\",\"authors\":\"Dolores Beteta Fernández , Carlos Pérez Cánovas , Rosa Belén Martínez Egea , Julián Alcaraz Martínez , Adriana Catarina De Souza Oliveira , Manuel Pardo Ríos\",\"doi\":\"10.1016/j.anpedi.2025.503998\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>The overall proportion of patients with at least one safety incident was 8.5% (95%<span>C</span>I: 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 (<em>P</em><.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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>\",\"PeriodicalId\":7783,\"journal\":{\"name\":\"Anales de pediatria\",\"volume\":\"103 4\",\"pages\":\"Article 503998\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anales de pediatria\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1695403325002334\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anales de pediatria","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1695403325002334","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
Incidentes de seguridad en urgencias pediátricas: incidencia, características y variabilidad entre centros. Estudio multicéntrico nacional
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.
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.