Incidence and preventability of adverse events in the emergency room of an orthopaedic traumatologic surgery unit

Gagneux, E; Tropet, Y.; Jm, Brientini; Vichard, Philippe

doi:10.1097/00063110-199606000-00004

Cited by 5 publications

(9 citation statements)

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“…This record consists of administrative and diagnostic data (using the international disease classification). In some situations, which were identified at risk for near adverse events by the previous study, 4 warnings appear on the screen during the data capture. For example, in the case of a traYc accident, the question "was the haemodynamic check up performed?"…”

Section: The Initial Assessment Of Near Adverse Events (1993)mentioning

confidence: 92%

“…In 1993, the first assessment included 2056 consecutive ambulatory cases, 4 and showed the incidence of near adverse events to be 9.9% (n=204), during a period of 10 weeks, from 13 November 1992 to 20 January 1993. Failure to follow preventive procedures constituted 67% of the near adverse events, with antitetanus procedures heading the list (60% of all near adverse events).…”

Section: Quality Assurance Programmementioning

confidence: 99%

“…For example, the studies in our emergency unit showed that although 60% of problems with the quality of care would be dealt with by prevention protocols, 40% encompassed such a variety of situations that any standardising process was impossible. 4 On the other hand, even if standardisation of all care processes were possible by developing critical pathways and algorithms 5 ; such a situation is not acceptable. Standardising every process means a rigid and locked in system.…”

Section: Introductionmentioning

confidence: 99%

“…However, there is a direct relation between the occurrence of near adverse events and the incidence of adverse events, 10 and measuring the occurrence of near adverse events is a good indicator in technical assessment of quality of care. 4 Few studies have been done on adverse events (or near adverse events) in emergency units, [11][12][13] and to our knowledge, only one has been carried out in an orthopaedic and trauma surgery unit. 4 The introduction of quality assurance measures is still experimental, [14][15][16] and most of the reports have a follow up of less than one year.…”

Section: Introductionmentioning

confidence: 99%

“…4 Few studies have been done on adverse events (or near adverse events) in emergency units, [11][12][13] and to our knowledge, only one has been carried out in an orthopaedic and trauma surgery unit. 4 The introduction of quality assurance measures is still experimental, [14][15][16] and most of the reports have a follow up of less than one year. [17][18][19] In 1993, after an initial assessment of near adverse events (at risk events causing situations which could lead to the occurrence of an adverse event) in the emergency room of the orthopaedic, trauma, and plastic surgery unit of Jean Minjoz Hospital in Besançon (France) (box), 4 a quality assurance programme was initiated.…”

Section: Introductionmentioning

confidence: 99%

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Trauma emergency unit: long-term evaluation of a quality assurance programme

Gagneux

Vichard²

1998

Quality and Safety in Health Care

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Objective-Long term evaluation of a quality assurance programme (after an assessment in 1993). Design-Review of medical records. Setting-Emergency area of an orthopaedic, trauma, and plastic surgery unit in a French teaching hospital (Besançon). Subjects-1187 consecutive ambulatory patients' records, from July 1995. Main measures-Occurrence of near adverse events (at risk events causing situations which could lead to the occurrence of an adverse event). Results-71 near adverse events were identified (5.9% of the ambulatory visits). There was a significant decrease in the rate of near adverse events between 1993 (9.9% (2056 ambulatory visits, 204 near adverse events)), and 1995 (5.9% (1187 ambulatory visits, 71 near adverse events)), and significant change in the proportion of each category of adverse event (decrease in departures from prevention protocols). Conclusions-Despite their limitations, the eVectiveness and eYciency of quality assurance programmes seem to be real and valuable. Maintaining quality improvement requires conditions which include some of the basic principles of total quality management (leadership, participatory management, openness, continuous feed back). The organisation of this unit as a specialised trauma centre was also a determining factor in the feasibility of a quality assurance programme (specialisation and small size, high activity volume, management of the complete care process). Quality assurance is an important initial step towards quality improvement, that should precede consideration of a total quality management programme.

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Section: The Initial Assessment Of Near Adverse Events (1993)mentioning

confidence: 92%

Section: Quality Assurance Programmementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Trauma emergency unit: long-term evaluation of a quality assurance programme

Gagneux

Vichard²

1998

Quality and Safety in Health Care

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Adverse events in acute care: An integrative literature review

Kellogg

Havens

2003

Research in Nursing & Health

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An integrative literature review was conducted to investigate studies on adverse events reported in medical, health services, and nursing literature. The review was guided by the method proposed by Jackson (1980) and Ganong (1987). Three questions shaped the review: (a) What terms are used to denote adverse events? (b) What purposes drive adverse events research? and (c) What data sources are used to study adverse events? Adverse events was the dominant term, the study of adverse events as an outcome variable was the prevailing research purpose, and monitoring or screening the patient clinical record and self-reported incidents by health care professionals were the main data sources. Future research is recommended to conceptualize and study adverse events.

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Diagnostic Errors in Orthopedic Surgery

et al. 2012

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The need for accuracy in neurovascular examinations of the extremities of trauma patients is well recognized. The goals of this study were to (a) evaluate the completeness of orthopedic house staff documentation of the neurovascular status of adult patients with extremity trauma, (b) identify the frequency of individual element documentation, and (c) determine if completeness was related to experience. The trauma center's database was reviewed for patients with extremity injuries (June 2006 through January 2008). For 114 patients, the authors assessed the neurovascular examination documentation for completeness (sensory, motor function, and vascular elements) and "perfection" (complete bilateral elements), identified the frequency of individual element documentation, and determined the relationship of completeness to experience (Pearson correlation coefficients; significance, P ≤ .05). There was no complete (all elements) or perfect (complete bilateral) documentation. The element most often documented completely was the sensory examination. Increased examiner experience was significantly associated with decreased sensory and vascular documentation.

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Incidence and preventability of adverse events in the emergency room of an orthopaedic traumatologic surgery unit

Cited by 5 publications

References 0 publications

Trauma emergency unit: long-term evaluation of a quality assurance programme

Trauma emergency unit: long-term evaluation of a quality assurance programme

Adverse events in acute care: An integrative literature review

Diagnostic Errors in Orthopedic Surgery

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