PMID- 30006445 OWN - NLM STAT- MEDLINE DCOM- 20190502 LR - 20200306 IS - 1098-4275 (Electronic) IS - 0031-4005 (Print) IS - 0031-4005 (Linking) VI - 142 IP - 2 DP - 2018 Aug TI - Adverse Events in Hospitalized Pediatric Patients. LID - 10.1542/peds.2017-3360 [doi] LID - e20173360 AB - : media-1vid110.1542/5789657761001PEDS-VA_2017-3360Video Abstract BACKGROUND: Patient safety concerns over the past 2 decades have prompted widespread efforts to reduce adverse events (AEs). It is unclear whether these efforts have resulted in reductions in hospital-wide AE rates. We used a validated safety surveillance tool, the Global Assessment of Pediatric Patient Safety, to measure temporal trends (2007-2012) in AE rates among hospitalized children. METHODS: We conducted a retrospective surveillance study of randomly selected pediatric inpatient records from 16 teaching and nonteaching hospitals. We constructed Poisson regression models with hospital random intercepts, controlling for patient age, sex, insurance, and chronic conditions, to estimate changes in AE rates over time. RESULTS: Examining 3790 records, reviewers identified 414 AEs (19.1 AEs per 1000 patient days; 95% confidence interval [CI] 17.2-20.9) and 210 preventable AEs (9.5 AEs per 1000 patient days; 95% CI 8.2-10.8). On average, teaching hospitals had higher AE rates than nonteaching hospitals (26.2 [95% CI 23.7-29.0] vs 5.1 [95% CI 3.7-7.1] AEs per 1000 patient days, P < .001). Chronically ill children had higher AE rates than patients without chronic conditions (33.9 [95% CI 24.5-47.0] vs 14.0 [95% CI 11.8-16.5] AEs per 1000 patient days, P < .001). Multivariate analyses revealed no significant changes in AE rates over time. When stratified by hospital type, neither teaching nor nonteaching hospitals experienced significant temporal AE rate variations. CONCLUSIONS: AE rates in pediatric inpatients are high and did not improve from 2007 to 2012. Pediatric AE rates were substantially higher in teaching hospitals as well as in patients with more chronic conditions. CI - Copyright (c) 2018 by the American Academy of Pediatrics. FAU - Stockwell, David C AU - Stockwell DC AD - Children's National Medical Center, Washington, District of Columbia. AD - Division of Critical Care Medicine, Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia. FAU - Landrigan, Christopher P AU - Landrigan CP AD - Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts. AD - Harvard Medical School, Harvard University, Boston, Massachusetts. AD - Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. FAU - Toomey, Sara L AU - Toomey SL AD - Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts. AD - Harvard Medical School, Harvard University, Boston, Massachusetts. FAU - Loren, Samuel S AU - Loren SS AD - Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts. FAU - Jang, Jisun AU - Jang J AD - Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts. FAU - Quinn, Jessica A AU - Quinn JA AD - Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts. FAU - Ashrafzadeh, Sepideh AU - Ashrafzadeh S AD - Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts. FAU - Wang, Michelle J AU - Wang MJ AD - Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts. FAU - Wu, Melody AU - Wu M AD - Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts. FAU - Sharek, Paul J AU - Sharek PJ AD - Division of Pediatric Hospitalist Medicine, Department of Pediatrics, School of Medicine, Stanford University, Stanford, California. FAU - Classen, David C AU - Classen DC AD - Division of Clinical Epidemiology, Department of Internal Medicine and. FAU - Srivastava, Rajendu AU - Srivastava R AD - Division of Inpatient Medicine, Department of Pediatrics, University of Utah, Salt Lake City, Utah. AD - Primary Children's Hospital and. AD - Institute for Healthcare Delivery Research, Intermountain Healthcare, Salt Lake City, Utah; and. FAU - Parry, Gareth AU - Parry G AD - Harvard Medical School, Harvard University, Boston, Massachusetts. AD - Institute for Healthcare Improvement, Cambridge, Massachusetts. FAU - Schuster, Mark A AU - Schuster MA AD - Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts; mark.a.schuster@kp.org. AD - Harvard Medical School, Harvard University, Boston, Massachusetts. CN - GAPPS Study Group LA - eng GR - U18 HS020513/HS/AHRQ HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20180713 PL - United States TA - Pediatrics JT - Pediatrics JID - 0376422 SB - IM CIN - Pediatrics. 2018 Aug;142(2):. PMID: 30006444 CIN - J Pediatr. 2018 Nov;202:330-333. PMID: 30360872 MH - Child MH - Child, Hospitalized MH - Electronic Health Records/trends MH - Female MH - Hospitalization/*trends MH - Humans MH - Iatrogenic Disease/*epidemiology/prevention & control MH - Male MH - Medical Errors/prevention & control/*trends MH - Patient Safety/standards MH - Random Allocation MH - Retrospective Studies PMC - PMC6317760 COIS- POTENTIAL CONFLICT OF INTEREST: Drs Stockwell and Classen disclose that they are employees for Pascal Metrics, a Patient Safety Organization; the other authors have indicated they have no potential conflicts of interest to disclose. EDAT- 2018/07/15 06:00 MHDA- 2019/05/03 06:00 PMCR- 2019/08/01 CRDT- 2018/07/15 06:00 PHST- 2018/04/30 00:00 [accepted] PHST- 2018/07/15 06:00 [pubmed] PHST- 2019/05/03 06:00 [medline] PHST- 2018/07/15 06:00 [entrez] PHST- 2019/08/01 00:00 [pmc-release] AID - peds.2017-3360 [pii] AID - 10.1542/peds.2017-3360 [doi] PST - ppublish SO - Pediatrics. 2018 Aug;142(2):e20173360. doi: 10.1542/peds.2017-3360. Epub 2018 Jul 13.