Documentation and disclosure of adverse events that led to compensated patient injury in a Norwegian university hospital

Smeby, Susanne Skjervold; Johnsen, Roar; Marhaug, G.

doi:10.1093/intqhc/mzv084

Cited by 20 publications

(8 citation statements)

References 26 publications

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“…However, all these methods give only a partial picture of AE. Reporting systems, operating generally at local level, are strongly dependent on the willingness of staff and local quality culture [16]. Safety indicators based on routinely collected data are promising to allow hospitals to benchmark their performance but most suffer from validity concerns due to medical information inaccuracy or incompleteness and case-mix bias [17,18].…”

Section: Introductionmentioning

confidence: 99%

Adverse events related to hospital care: a retrospective medical records review in a Swiss hospital

Halfon

Staines

Burnand

2017

International Journal for Quality in Health Care

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Section: Introductionmentioning

confidence: 99%

Adverse events related to hospital care: a retrospective medical records review in a Swiss hospital

Halfon

Staines

Burnand

2017

International Journal for Quality in Health Care

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“…A standardized reporting and documentation of both adverse events and reactions is essential [35,61,62]. For drug safety, the FDA developed a reporting system in 1998 [63].…”

Section: Discussionmentioning

confidence: 99%

“…We think that both patients' and physicians' reports should be included when evaluating safety aspects of a medical intervention while electronic documentation tools might support this. Patients (or their relatives) can play an important role in signalling safety aspects in clinical trials as well as in routine care [62,69] and can help the patient-centred approach in the future.…”

Section: Discussionmentioning

confidence: 99%

Comparing physicians’ and patients’ reporting on adverse reactions in randomized trials on acupuncture—a secondary data analysis

Schwaneberg

Witt

Roll

et al. 2019

BMC Complement Altern Med

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Background: We aimed to compare patients' and physicians' safety reporting using data from large acupuncture trials (44,818 patients) and to determine associations between patient characteristics and reporting of adverse reactions. Methods: Six pragmatic randomized trials with an additional non-randomized study arm that included those patients who refused randomization were evaluated. Patients received acupuncture treatment for osteoarthritis of the hip or knee, chronic neck pain, chronic low back pain, chronic headache, dysmenorrhea, or allergic rhinitis or asthma. Safety outcomes were evaluated by questionnaires from both the physicians and the patients. To determine level of agreement between physicians and patients on the prevalence of adverse reactions, Cohen's kappa was used. With multilevel models associations between patient characteristics and reporting of adverse reactions were assessed. Results: Patients reported on average three times more adverse reactions than the study physicians: for bleeding/ haematoma, 6.7% of patients (n = 2458) vs. 0.6% of physicians (n = 255) and for pain, 1.7% of patients (n = 636) vs. 0.5% of physicians (n = 207). We found only minor agreements between patients and physicians (maximum Cohen's kappa: 0.50, 95% confidence interval [0.49;0.51] for depressive mood). Being a female and participation in the randomization were associated with higher odds of reporting an adverse reaction. Conclusions: In our study, patients' and physicians' reports on adverse reactions of acupuncture differed substantially, possibly due to differences in patients' and physicians' questionnaires and definitions. For the assessment of safety, we strongly support the inclusion of patients' and physicians' reports while ensuring standardization of data collection and definitions.

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“…Nevertheless, even if Norway has a mandatory reporting system for the most severe adverse events, underreporting in documentation and disclosure of adverse events in hospitals remains a problem. Studies show that only one in four adverse events causing injury or death are reported through incident reporting systems in hospitals (Smeby et al, 2015).…”

Section: Adverse Events In Cancer Treatment In Norwaymentioning

confidence: 99%

Challenges in Obtaining and Sharing Core Patient Information in Norwegian Nursing Homes and Home Care Services: A Qualitative Study of Nurses’ and Doctors’ Experiences

Manskow¹,

Kristiansen²

2022

Medication Safety in Municipal Health and Care Services

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In Norwegian nursing homes and home care services, medication information and other core patient information (CPI) is usually registered and stored in separate digital systems not connected to each other. This may pose a threat to medication safety and quality of care in municipal health and care services. This study explores how nurses and doctors in Norwegian nursing homes and home care services experience access to and exchange of CPI before two new national solutions, the Shared Medication List and the Summary Care Record, are implemented in Norway. We used a qualitative research design with semi-structured individual interviews with nurses (n = 17) and medical doctors (n = 6) from home care services and nursing homes in six Norwegian municipalities. Data were coded and analyzed following an approach based on grounded theory. Our participants reported having extensive experience of various challenges related to accessing and sharing CPI. Five main challenges emerged from our data: 1) excessive time consumption; 2) frustration; 3) uncertainty; 4) dependence; and 5) complexity and risk. Our participants thought that these challenges posed a risk to patient safety and quality of care, and they were especially concerned about medication information in patient transitions between levels of care. Our study shows that nurses and medical doctors face substantial challenges, because they lack seamless, up-to-date digital solutions able to share CPI across healthcare services. The ongoing national implementation of the SML and SCR should address these challenges directly, and closely evaluate their impact on patient safety and quality of care.

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Documentation and disclosure of adverse events that led to compensated patient injury in a Norwegian university hospital

Abstract: Underreporting and nondisclosure of patient injuries remain a problem, despite a mandatory reporting system. Helping physicians and surgeons recognize adverse events, reporting them and discussing them with patients should be a priority for hospitals and medical schools.

Cited by 20 publications

References 26 publications

Adverse events related to hospital care: a retrospective medical records review in a Swiss hospital

Adverse events related to hospital care: a retrospective medical records review in a Swiss hospital

Comparing physicians’ and patients’ reporting on adverse reactions in randomized trials on acupuncture—a secondary data analysis

Challenges in Obtaining and Sharing Core Patient Information in Norwegian Nursing Homes and Home Care Services: A Qualitative Study of Nurses’ and Doctors’ Experiences

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