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Adverse events in patients in home healthcare: a retrospective record review using trigger tool methodology.
Linnéuniversitetet.
Danderyds sjukhus, Karolinska institutet.
Linnéuniversitetet, Karolinska institutet.
Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Kungliga tekniska högskolan .ORCID iD: 0000-0001-8246-9168
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2018 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 1, article id e019267Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Home healthcare is an increasingly common part of healthcare. The patients are often aged, frail and have multiple diseases, and multiple caregivers are involved in their treatment. This study explores the origin, incidence, types and preventability of adverse events (AEs) that occur in patients receiving home healthcare.

DESIGN: A study using retrospective record review and trigger tool methodology.

SETTING AND METHODS: Ten teams with experience of home healthcare from nine regions across Sweden reviewed home healthcare records in a two-stage procedure using 38 predefined triggers in four modules. A random sample of records from 600 patients (aged 18 years or older) receiving home healthcare during 2015 were reviewed.

PRIMARY AND SECONDARY OUTCOME MEASURES: The cumulative incidence of AEs found in patients receiving home healthcare; secondary measures were origin, types, severity of harm and preventability of the AEs.

RESULTS: The patients were aged 20-79 years, 280 men and 320 women. The review teams identified 356 AEs in 226 (37.7%; 95% CI 33.0 to 42.8) of the home healthcare records. Of these, 255 (71.6%; 95% CI 63.2 to 80.8) were assessed as being preventable, and most (246, 69.1%; 95% CI 60.9 to 78.2) required extra healthcare visits or led to a prolonged period of healthcare. Most of the AEs (271, 76.1%; 95% CI 67.5 to 85.6) originated in home healthcare; the rest were detected during home healthcare but were related to care outside home healthcare. The most common AEs were healthcare-associated infections, falls and pressure ulcers.

CONCLUSIONS: AEs in patients receiving home healthcare are common, mostly preventable and often cause temporary harm requiring extra healthcare resources. The most frequent types of AEs must be addressed and reduced through improvements in interprofessional collaboration. This is an important area for future studies.

Place, publisher, year, edition, pages
2018. Vol. 8, no 1, article id e019267
Keywords [en]
Home health care, Patient harm, Patient safety, Quality in health care, Trigger tool
National Category
Nursing
Identifiers
URN: urn:nbn:se:esh:diva-7104DOI: 10.1136/bmjopen-2017-019267PubMedID: 29301764OAI: oai:DiVA.org:esh-7104DiVA, id: diva2:1262907
Available from: 2018-11-13 Created: 2018-11-13 Last updated: 2019-09-09Bibliographically approved

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