PMID- 27585910
OWN - NLM
STAT- MEDLINE
DCOM- 20171128
LR  - 20190318
IS  - 1432-5195 (Electronic)
IS  - 0341-2695 (Linking)
VI  - 40
IP  - 11
DP  - 2016 Nov
TI  - Incidence and preventability of adverse events in an orthopaedic unit: a 
      prospective analysis of four thousand, nine hundred and six admissions.
PG  - 2233-2238
AB  - PURPOSE: We aimed to identify the incidence and preventability rate of adverse 
      events (AEs) occurring in a specialty orthopaedic unit. METHODS: Four thousand 
      nine hundred and six consecutive in-patient admissions over six months in an 
      orthopaedic unit were prospectively analysed. The total indoor patient capacity 
      was segregated into 25-bed units each, and AEs were recorded on a daily basis by 
      two observers. Each event was assessed by allotting a causation score (1-6), with 
      a score of >/= 4 implying a systemic/individual failure of healthcare provision. A 
      preventability score (1-6) was allotted and scores >/= 4 were considered to be 
      preventable. RESULTS: Four hundred and sixty-seven patients (9.5 %) suffered a 
      total of 529 AEs, including 127 readmissions; 49 patients suffering multiple 
      events. Three hundred and thirty-three (62.9 %) events had a causation score 
      of >/= 4, indicating a failure of healthcare delivery systems. Three hundred and 
      one (56.8 %) events could have been prevented with better regulation and 
      adherence to management protocols. Hospital-acquired infections were the most 
      common event, with surgical-site infection in 102 cases (19.2 and 2 % overall) 
      and catheter-associated urinary tract infections noted in 45 (8.5 %) patients. 
      Medical events included seven deep vein thrombosis, two pulmonary embolisms, five 
      myocardial infarctions and one stroke. AEs occurred 56.3 % in the ward, 4.3 % in 
      the intensive care unit (ICU), 6.2 % in the emergency room, and 9.0 % in the 
      operating theatre. CONCLUSION: This prospective study documented an adverse event 
      rate of 9.5 %, of which 56 % were preventable. AEs occurred in all stages of 
      treatment care, emphasising the need for vigilance during the entire treatment 
      process.
FAU - Rajasekaran, Shanmuganathan
AU  - Rajasekaran S
AD  - Department of Orthopaedic Surgery, Ganga Hospital, 313, Mettupalayam Road, 
      Coimbatore, India. sr@gangahospital.com.
FAU - Ravi, Srikesh
AU  - Ravi S
AD  - Department of Orthopaedic Surgery, Ganga Hospital, 313, Mettupalayam Road, 
      Coimbatore, India.
FAU - Aiyer, Siddharth N
AU  - Aiyer SN
AD  - Department of Orthopaedic Surgery, Ganga Hospital, 313, Mettupalayam Road, 
      Coimbatore, India.
LA  - eng
PT  - Journal Article
DEP - 20160901
PL  - Germany
TA  - Int Orthop
JT  - International orthopaedics
JID - 7705431
SB  - IM
MH  - Adult
MH  - Aged
MH  - Emergency Service, Hospital
MH  - Female
MH  - Hospitals
MH  - Humans
MH  - Incidence
MH  - Intensive Care Units/*statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Orthopedics/*statistics & numerical data
MH  - Patient Admission/*statistics & numerical data
MH  - Prospective Studies
OTO - NOTNLM
OT  - *Adverse event
OT  - *Disability
OT  - *Hospital-acquired infection
OT  - *Injury
OT  - *Prevention
OT  - *Quality in health care
EDAT- 2016/10/28 06:00
MHDA- 2017/11/29 06:00
CRDT- 2016/09/03 06:00
PHST- 2016/08/08 00:00 [received]
PHST- 2016/08/10 00:00 [accepted]
PHST- 2016/10/28 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
PHST- 2016/09/03 06:00 [entrez]
AID - 10.1007/s00264-016-3282-4 [pii]
AID - 10.1007/s00264-016-3282-4 [doi]
PST - ppublish
SO  - Int Orthop. 2016 Nov;40(11):2233-2238. doi: 10.1007/s00264-016-3282-4. Epub 2016 
      Sep 1.