Which Adverse Events Are Related to Health Care during Hospitalization in Elderly Inpatients?

Abstract

Background: Adverse events result in longer hospital stays and increase costs and mortality. We aimed to assess incidence of adverse events occurring during hospitalization in a post-emergency unit and to describe their characteristics.Methods: All adverse events occurring in patients during their hospitalization in a post-emergency unit in a French university hospital (20 beds) were systematically and consecutively recorded from September 2009 to February 2011. Patients with adverse events were compared to up to three control patients, matched for date of admission +/- age in the same unit.Results: We identified 56 patients with 64 adverse events, giving an incidence of 3.0/100 patients admitted/year. Fifty-one adverse events were drug-related. Patients had a median age of 82.5 years with a male/female ratio of 1/1.4. They presented a median Charlson score of 1 and the median number of medications was 6. The drugs most frequently involved in drug-related events were nervous system drugs (47%) and anti-infectives (22%). In multivariate analysis, a Charlson score ≥ 2 was associated with the occurrence of adverse events (OR 0.4; 95% CI [0.21 - 0.80]).Conclusions: Systematic recording showed that adverse events were not rare in a post-emergency unit. Patients with comorbid conditions were less likely to present an adverse event, possibly because of greater precautions taken by the medical team.

Prevalência De Eventos Adversos Entre Idosos Internados Em Unidade De Clínica Cirúrgica

“…O tempo de internação também pode ter contribuído para essa elevada prevalência, podendo ser tanto causa como consequência dos eventos adversos, pois sua ocorrência, durante a hospitalização, frequentemente prolonga o tempo de permanência na instituição de saúde (2,3) . Ao mesmo tempo, a permanência do paciente na instituição aumenta o risco de ocorrência desses eventos (11) .…”

“…O paciente idoso, no contexto hospitalar, representa um grupo altamente exposto à ocorrência de eventos adversos durante a prática assistencial, seja pela recuperação mais lenta, que prolonga o tempo de internação, seja pelo tipo de cuidado que necessita, seja, ainda, pela fragilidade pró-pria do ciclo de vida (2)(3)(4) . Entende-se evento adverso como um incidente decorrente da atenção à saúde, que resultou em algum tipo de dano ao paciente, podendo ser físico, social ou psicológico, o que inclui doença, lesão, sofrimento, incapacidade ou morte (5) .…”

“…Diante da grande parcela de idosos que utilizam os serviços de saúde, da susceptibilidade para a ocorrência de eventos adversos, dos altos custos relacionados aos modelos de atenção à saúde do idoso e às tentativas de minimizar os efeitos dos eventos adversos no paciente (1)(2)(3)(4)6) , este estudo justifica-se e poderá auxiliar na elaboração de estratégias mais eficazes para a sua prevenção durante a internação.…”

Vital Signs Measurement: An Indicator of Safe Care Delivered to Elderly Patients

“…[12][13] Failure to record the vitals signs of patients in medical records hampers the communication of information, which compromises the assessment of nursing interventions and care delivery. [9][10]14 When providing care to elderly patients, healthcare providers are expected to take observation and patient-professional relationships beyond what is traditionally done, given the vulnerability and specificity associated with changes that take place due to aging.…”

“…[6][7] Due to the loss of homeostasis protection mechanisms related to senescence, elderly individuals are more vulnerable to the after-effects of diseases, which contribute to longer hospitalizations and greater costs for the healthcare services. [8][9][10] The purpose of serially assessing a patient's vitals signs is to prevent harm and the early identification of events with a potential to affect the quality of healing actions. Additionally, the identification of these parameters helps to reduce the risk of unnecessary harm associated with healthcare delivery to an acceptable level, 11 by achieving quality care and patient safety, which are priorities for all the professionals involved in the care process.…”