Doran Diane, Hirdes John P, Blais Régis, Baker G Ross, Poss Jeff W, Li Xiaoqiang, Dill Donna, Gruneir Andrea, Heckman George, Lacroix Hélène, Mitchell Lori, O'Beirne Maeve, Foebel Andrea, White Nancy, Qian Gan, Nahm Sang-Myong, Yim Odilia, Droppo Lisa, McIsaac Corrine
Professor Emeritus, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON.
Healthc Policy. 2013 Aug;9(1):76-88.
The occurrence of adverse events (AEs) in care settings is a patient safety concern that has significant consequences across healthcare systems. Patient safety problems have been well documented in acute care settings; however, similar data for clients in home care (HC) settings in Canada are limited. The purpose of this Canadian study was to investigate AEs in HC, specifically those associated with hospitalization or detected through the Resident Assessment Instrument for Home Care (RAI-HC).
A retrospective cohort design was used. The cohort consisted of HC clients from the provinces of Nova Scotia, Ontario, British Columbia and the Winnipeg Regional Health Authority.
The overall incidence rate of AEs associated with hospitalization ranged from 6% to 9%. The incidence rate of AEs determined from the RAI-HC was 4%. Injurious falls, injuries from other than fall and medication-related events were the most frequent AEs associated with hospitalization, whereas new caregiver distress was the most frequent AE identified through the RAI-HC.
The incidence of AEs from all sources of data ranged from 4% to 9%. More resources are needed to target strategies for addressing safety risks in HC in a broader context. Tools such as the RAI-HC and its Clinical Assessment Protocols, already available in Canada, could be very useful in the assessment and management of HC clients who are at safety risk.
医疗机构中不良事件（AE）的发生是一个患者安全问题，在整个医疗系统中会产生重大后果。急性护理环境中的患者安全问题已有充分记录；然而，加拿大居家护理（HC）环境中客户的类似数据有限。这项加拿大研究的目的是调查居家护理中的不良事件，特别是那些与住院相关的或通过居家护理居民评估工具（RAI-HC）检测到的不良事件。
采用回顾性队列设计。该队列包括来自新斯科舍省、安大略省、不列颠哥伦比亚省和温尼伯地区卫生局的居家护理客户。
与住院相关的不良事件总体发生率在6%至9%之间。通过RAI-HC确定的不良事件发生率为4%。伤害性跌倒、非跌倒伤害和药物相关事件是与住院相关的最常见不良事件，而新的护理人员困扰是通过RAI-HC确定的最常见不良事件。
所有数据来源的不良事件发生率在4%至9%之间。需要更多资源来制定在更广泛背景下解决居家护理安全风险的策略。加拿大已经有RAI-HC及其临床评估协议等工具，这些工具在评估和管理有安全风险的居家护理客户方面可能非常有用。
