PMID- 23283731
OWN - NLM
STAT- MEDLINE
DCOM- 20130730
LR  - 20220408
IS  - 1464-3677 (Electronic)
IS  - 1353-4505 (Linking)
VI  - 25
IP  - 1
DP  - 2013 Feb
TI  - The incidence of adverse events among home care patients.
PG  - 16-28
LID - 10.1093/intqhc/mzs075 [doi]
AB  - OBJECTIVE: 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: 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: Three publicly funded home care programs in 
      Ontario, Canada. MAIN OUTCOME MEASURES: Prevalence and types of AEs; ratings of 
      preventability. RESULTS: 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: 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.
FAU - Sears, Nancy
AU  - Sears N
AD  - Department of Health Sciences, St. Lawrence College, Room 33260, 100 Portsmouth 
      Avenue, Kingston, ON, Canada K7L 5A6. nsears@sl.on.ca
FAU - Baker, G Ross
AU  - Baker GR
FAU - Barnsley, Jan
AU  - Barnsley J
FAU - Shortt, Sam
AU  - Shortt S
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130102
PL  - England
TA  - Int J Qual Health Care
JT  - International journal for quality in health care : journal of the International 
      Society for Quality in Health Care
JID - 9434628
SB  - IM
MH  - Accidental Falls/statistics & numerical data
MH  - Aged
MH  - Confidence Intervals
MH  - Female
MH  - Home Care Services/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Mass Screening
MH  - Medical Audit
MH  - Medical Errors/classification/prevention & control/*statistics & numerical data
MH  - Odds Ratio
MH  - Ontario
MH  - Patient Safety/*statistics & numerical data
MH  - Retrospective Studies
MH  - Risk Factors
EDAT- 2013/01/04 06:00
MHDA- 2013/07/31 06:00
CRDT- 2013/01/04 06:00
PHST- 2013/01/04 06:00 [entrez]
PHST- 2013/01/04 06:00 [pubmed]
PHST- 2013/07/31 06:00 [medline]
AID - mzs075 [pii]
AID - 10.1093/intqhc/mzs075 [doi]
PST - ppublish
SO  - Int J Qual Health Care. 2013 Feb;25(1):16-28. doi: 10.1093/intqhc/mzs075. Epub 
      2013 Jan 2.