PMID- 29301764
OWN - NLM
STAT- MEDLINE
DCOM- 20180817
LR  - 20190202
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 8
IP  - 1
DP  - 2018 Jan 3
TI  - Adverse events in patients in home healthcare: a retrospective record review 
      using trigger tool methodology.
PG  - e019267
LID - 10.1136/bmjopen-2017-019267 [doi]
LID - e019267
AB  - OBJECTIVE: Home healthcare is an increasingly common part of healthcare. The 
      patients are often aged, frail and have multiple diseases, and multiple 
      caregivers are involved in their treatment. This study explores the origin, 
      incidence, types and preventability of adverse events (AEs) that occur in 
      patients receiving home healthcare. DESIGN: A study using retrospective record 
      review and trigger tool methodology. SETTING AND METHODS: Ten teams with 
      experience of home healthcare from nine regions across Sweden reviewed home 
      healthcare records in a two-stage procedure using 38 predefined triggers in four 
      modules. A random sample of records from 600 patients (aged 18 years or older) 
      receiving home healthcare during 2015 were reviewed. PRIMARY AND SECONDARY 
      OUTCOME MEASURES: The cumulative incidence of AEs found in patients receiving 
      home healthcare; secondary measures were origin, types, severity of harm and 
      preventability of the AEs. RESULTS: The patients were aged 20-79 years, 280 men 
      and 320 women. The review teams identified 356 AEs in 226 (37.7%; 95% CI 33.0 to 
      42.8) of the home healthcare records. Of these, 255 (71.6%; 95% CI 63.2 to 80.8) 
      were assessed as being preventable, and most (246, 69.1%; 95% CI 60.9 to 78.2) 
      required extra healthcare visits or led to a prolonged period of healthcare. Most 
      of the AEs (271, 76.1%; 95% CI 67.5 to 85.6) originated in home healthcare; the 
      rest were detected during home healthcare but were related to care outside home 
      healthcare. The most common AEs were healthcare-associated infections, falls and 
      pressure ulcers. CONCLUSIONS: AEs in patients receiving home healthcare are 
      common, mostly preventable and often cause temporary harm requiring extra 
      healthcare resources. The most frequent types of AEs must be addressed and 
      reduced through improvements in interprofessional collaboration. This is an 
      important area for future studies.
CI  - (c) Article author(s) (or their employer(s) unless otherwise stated in the text of 
      the article) 2018. All rights reserved. No commercial use is permitted unless 
      otherwise expressly granted.
FAU - Schildmeijer, Kristina Gorel Ingegerd
AU  - Schildmeijer KGI
AD  - Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
FAU - Unbeck, Maria
AU  - Unbeck M
AD  - Department of Orthopaedics, Danderyd Hospital, Stockholm, Sweden.
AD  - Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, 
      Stockholm, Sweden.
FAU - Ekstedt, Mirjam
AU  - Ekstedt M
AD  - Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
AD  - Department of Learning, Informatics, Management and Ethics, Karolinska 
      Institutet, Stockholm, Sweden.
FAU - Lindblad, Marlene
AU  - Lindblad M
AD  - School of Technology and Health, Royal Institute of Technology, Stockholm, 
      Sweden.
AD  - Departement of Health Care Sciences, Ersta Skondal University College, Stockholm, 
      Sweden.
FAU - Nilsson, Lena
AU  - Nilsson L
AD  - Department of Anaesthesiology and Intensive Care, Department of Medical and 
      Health Sciences, Linkoping University, Linkoping, Sweden.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180103
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Accidental Falls/statistics & numerical data
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cross Infection/epidemiology
MH  - Female
MH  - Home Care Services/*standards
MH  - Humans
MH  - Incidence
MH  - Male
MH  - *Medical Errors
MH  - *Medical Records
MH  - Middle Aged
MH  - Patient Safety/*standards
MH  - Precipitating Factors
MH  - Pressure Ulcer/epidemiology
MH  - Retrospective Studies
MH  - Sweden/epidemiology
MH  - Young Adult
PMC - PMC5781156
OTO - NOTNLM
OT  - home health care
OT  - patient harm
OT  - patient safety
OT  - quality in health care
OT  - trigger tool
COIS- Competing interests: None declared.
EDAT- 2018/01/06 06:00
MHDA- 2018/08/18 06:00
PMCR- 2018/01/03
CRDT- 2018/01/06 06:00
PHST- 2018/01/06 06:00 [entrez]
PHST- 2018/01/06 06:00 [pubmed]
PHST- 2018/08/18 06:00 [medline]
PHST- 2018/01/03 00:00 [pmc-release]
AID - bmjopen-2017-019267 [pii]
AID - 10.1136/bmjopen-2017-019267 [doi]
PST - epublish
SO  - BMJ Open. 2018 Jan 3;8(1):e019267. doi: 10.1136/bmjopen-2017-019267.