Incidence and Determinants of Adverse Events among Older Inpatients in Post-Acute Rehabilitation Care: A Prospective Observational Study

Mirapeix, F Medina i; Sánchez, Mariano Gacto; Serrano, Francisco Javier Jimeno; Reina, P Escolar

doi:10.5152/tftrd.2015.44522

Cited by 4 publications

(5 citation statements)

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“…For instance, Saverino et al reported 40 fall events among 320 patients hospitalized for rehabilitation over a seven-month period, with 55% of the patients being male [ 30 ]. Additionally, Mirapeix et al highlighted falls as the most prevalent adverse events (AEs) in Post-Acute Rehabilitation Care, especially among individuals aged 75 years and above [ 31 ]. Tsur et al reported that 65% of fall events (n = 52) occurred during the daytime, 55% (n = 44) during transfers, 65% (n = 52) within the patient’s room, and only 18.8% (n = 15) in the toilet/bathroom.…”

Section: Discussionmentioning

confidence: 99%

Developing a fall prevention program in an inpatient spinal cord injury rehabilitation unit: A participatory action research study

Rahimi,

Khankeh,

Ebadi

et al. 2024

PLoS ONE

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Importance Spinal cord injury is a lifelong disability necessitating early management of falls during inpatient admissions. However, there is a paucity of research on fall prevention and management in Spinal cord injury rehabilitation. Objective(s) This study aimed at developing a fall prevention program in an inpatient rehabilitation Spinal cord injury unit. Method A participatory action research approach utilizing a before-and-after, mixed-method design was employed for this study. The study was performed at Rofaydeh Rehabilitation Hospital in Tehran, Iran, from 2021 to 2022. the study implemented Cohen’s four-stage model, encompassing the design of a change program, action, observation and evaluation, and feedback stages. A purposeful sampling method was utilized to select 19 nurses and members of the rehabilitation team from the hospital, ensuring maximum diversity. Data collection involved semi-structured interviews, focus groups, and a checklist for fall prevention measures. Qualitative content analysis, alongside descriptive (frequency, mean, and standard deviation) and inferential statistics (paired t-tests and Chi-square tests), were employed for data analysis. The study adhered to COREQ guidelines. Results Falls were most common among patients aged fifty years or older (P = 0.026). Throughout the study period, men were more likely to experience falls than women (P = 0.01). Preventive interventions have led to significant improvements in indicators of patient monitoring and care, patient education, and environmental safety, as demonstrated by a paired-sample t-test (P<0.001). Moreover, factors contributing to patients’ falls included "shortcomings in fall prevention policies" and "lack of knowledge and participation among patients and caregivers." Changes implemented in the Spinal Cord Injury unit involved enhancing interprofessional interactions, conducting educational workshops for patients and their companions, and identifying high-risk patients. These findings indicate a significant decrease in the incidence of falls following the intervention (P = 0.02). Conclusions The study found that a multifaceted intervention can increase knowledge about fall risks and substantially reduce both falls and associated minor injuries.

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Section: Discussionmentioning

confidence: 99%

Developing a fall prevention program in an inpatient spinal cord injury rehabilitation unit: A participatory action research study

Rahimi,

Khankeh,

Ebadi

et al. 2024

PLoS ONE

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“…For example, Saverino et al who reported 40 fall events among 320 patients hospitalized for rehabilitation during 7 months-period found that 55% of the patients were males [19]. Mirapeix et al also reported falls as the most prevalent AEs in inpatient rehabilitation hospitals, particularly among individuals above 75 years [14]. Additionally, Mandy et al demonstrated that fall was highly prevalent among patients with stroke and affected their daily lives [20].…”

Section: Discussionmentioning

confidence: 99%

“…The most prevalent AEs were delay in care provision (32.0%) and patient fall (28.0%) with 3 cases of death [13]. A retrospective study on elderly people referring to a post-acute rehabilitation hospital in France also found that 12% of this population group experienced AEs and the most common AE, particularly among participants over 75 years, were fall and nosocomial infections [14]; however, these studies focus on one specific population of patients and provide no comprehensive data about all patients who are hospitalized in inpatient rehabilitation hospitals.…”

Section: Introductionmentioning

confidence: 99%

Investigating the Prevalence, Severity, and Nature of Adverse Events in an Inpatient Rehabilitation Hospital

Rahimi,

Khankeh,

Arsalani

et al. 2023

IRJ

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Objectives: This study aims to evaluate the prevalence, severity, and nature of adverse events (AEs) and provide suggestions on how to prevent AEs recurrence in an inpatient rehabilitation hospital in Iran. Methods: This retrospective descriptive-analytical study was conducted in 2021 at Rofaydeh Rehabilitation Hospital in Tehran City, Iran. AEs associated with rehabilitation services and nursing care, which were reported in the hospital’s voluntary reporting system from 2018 to 2021 were evaluated. A standard checklist codified by the Ministry of Health of Iran was used to collect the data from the medical error documentation. The data were analyzed by the SPSS software, version 21, using descriptive statistics, the chi-square, and the Fisher exact tests. Results: A total of 5642 patients had been hospitalized in the study setting and 517 AEs had been documented during the 4 years of the study. The most common AEs in descending order were as follows: falls 288(55.7%), pressure ulcers 57(11.02%), medication errors 50(9.67%), clinical process 49(9.47%), clinical administration (issues with admission process 10(1.93%) and wrong patient identification 5(0.96%). Among 58(11.21%) cases of hospital-acquired infections, 45(77.58%) cases were urinary tract infections. There was a significant relationship between age and fall (P=0.026), pressure ulcer (P=0.006), and hospital-acquired infection (P=0.001), and between gender and fall (P=0.01), pressure ulcer (P=003), and hospital-acquired infection (P=0.01). The severity of identified AEs was categorized into mild 431(83.36%), moderate 61(11.79%), and severe 25(4.83%). The most common causes of AEs were limited supervision of patients by healthcare providers. Discussion: This study showed that patient fall, pressure ulcer, and hospital-acquired infection were the most prevalent AEs in the rehabilitation hospital. Future efforts to improve patient safety in these settings should focus on reducing such AEs along with removing barriers to voluntary incident reporting.

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“…Medina‐Mirapeix et al 6 in contrast did not report an adverse event incidence rate that had been normalized for patient length of stay and instead expressed prevalence as the percentage of patients affected by adverse events during rehabilitation. Adverse events affected 52.8% of patients in this study, compared to the Medina‐Mirapeix et al study in which 12% of the patients had incurred an adverse event.…”

Section: Discussionmentioning

confidence: 99%

“…Adverse events are defined as "negative consequences of care that results in unintended injury or illness which may or may not have been preventable". 5 Medina-Mirapeix et al 6 conducted a study of 216 postacute rehabilitation inpatients who were >65 years old in France and found that 12.0% had experienced at least one adverse event during their hospital stay. Falls and nosocomial infections were the most common.…”

Section: Introductionmentioning

confidence: 99%

The incidence and nature of adverse events in rehabilitation inpatients with acquired brain injuries

Guo

Mandurah

Tam

et al. 2021

PM&R

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Background: Patient safety is important in all healthcare settings. Few studies have examined the state of patient safety in rehabilitation and none have examined patient safety in the setting of acquired brain injury (ABI) rehabilitation. Objectives: To determine the incidence, most common types, and severities of adverse events among inpatients undergoing ABI rehabilitation. Design: Retrospective case series descriptive study. Setting: The inpatient ABI rehabilitation program at an academic, tertiary rehabilitation hospital in Canada. Participants: One hundred eight consecutive inpatients with acquired brain injuries. Interventions: Not applicable. Main Outcome Measures: Patient charts and incident reports from the hospital's voluntary reporting system were reviewed by three board-certified physiatrists to determine the incidence, type, severity and preventability of adverse events. Adverse events were identified and classified for severity and type using the World Health Organization (WHO) International Classification for Patient Safety. Preventability was rated on a six-point Likert scale. Results: During the study period, the incidence of adverse events was 17.42 AE 3.86 per 1000 patient days. Adverse events affected 52.8% of patients. Most adverse events identified were mild in severity (81.6%) and the rest were of moderate severity. The two most common types of adverse events were (1) patient incidents (50%) such as falls, pressure ulcers and skin tears and (2) patient behaviors such as missing patient, assault, or sexual behaviors (14.5%). Of the 76 adverse events identified in the study, 44.8% were preventable. The hospital's voluntary reporting system did not capture 57.9% of the adverse events identified. Conclusions: Future efforts to improve patient safety in ABI rehabilitation should focus on reducing falls, skin injuries and behaviors, and removing barriers to voluntary incident reporting. Detection of adverse events through chart reviews provides a more complete understanding of patient safety risks in ABI rehab than relying on incident reporting alone.

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Incidence and Determinants of Adverse Events among Older Inpatients in Post-Acute Rehabilitation Care: A Prospective Observational Study

Cited by 4 publications

References 0 publications

Developing a fall prevention program in an inpatient spinal cord injury rehabilitation unit: A participatory action research study

Developing a fall prevention program in an inpatient spinal cord injury rehabilitation unit: A participatory action research study

Investigating the Prevalence, Severity, and Nature of Adverse Events in an Inpatient Rehabilitation Hospital

The incidence and nature of adverse events in rehabilitation inpatients with acquired brain injuries

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