Lancis-Sepúlveda M L, Asenjo-Araya C
Unidad de Gestión de Riesgos, Clínica Vespucio, Santiago, Chile.
Dirección Médica, Clínica Vespucio, Santiago, Chile.
Rev Calid Asist. 2014 Mar-Apr;29(2):78-83. doi: 10.1016/j.cali.2013.10.003. Epub 2014 Mar 12.
To determine the incidence and type of adverse events (AE) in hospitalized patients in Vespucio Clinic, to describe their immediate causes, define avoidable AE and determine the services with highest AE rate.
Retrospective cohort study, in patients discharged between 16 and 31 January 2012. For the identification of AE, medical history was reviewed, and the AE screening guide adapted from the Harvard study was applied. The Spanish version of Modular Review Form MRF2 used in the ENEAS 2005 Study was applied to the patients with positive screening.
From the 500 patients studied, 31 had some AE related to health care (6.2%), with an incidence of 3.46 for every 100 patient bed days (minor events 2.72, moderate 0.65, and severe 0.09). The associated processes were: Care 32.4%, medication 13.5%, infections associated with health care 10.8%, and diagnostics 8.1%. More than two-thirds (67.6%) were considered avoidable. Of the adverse events, 40.5% required additional procedures, and 35.1% additional treatment. Hospital stay was extended by an average of 5.5 days in 5.4%, and 8.11% led to re-admission. Most of them (91.9% did not cause any incapacity. The departments with the highest AE rates per 100 bed patients days were: Critical Care Unit (21.4), obstetrics and gynecology (7), and medical/surgical wards (6) CONCLUSIONS: This is the first study conducted in a private hospital in our country that allowed us to identify the incidence, overall rate, and the rate by departments of adverse events, their severity, preventability and causal factors.
确定维斯普西奥诊所住院患者不良事件（AE）的发生率和类型，描述其直接原因，定义可避免的不良事件，并确定不良事件发生率最高的科室。
回顾性队列研究，研究对象为2012年1月16日至31日出院的患者。为识别不良事件，查阅了病史，并应用了根据哈佛研究改编的不良事件筛查指南。对筛查呈阳性的患者应用了2005年ENEAS研究中使用的西班牙语版模块化评审表MRF2。
在研究的500名患者中，31名发生了与医疗保健相关的不良事件（6.2%），每100个患者床日的发生率为3.46（轻微事件2.72，中度0.65，重度0.09）。相关过程包括：护理32.4%，用药13.5%，医疗保健相关感染10.8%，诊断8.1%。超过三分之二（67.6%）被认为是可避免的。在不良事件中，40.5%需要额外的程序，35.1%需要额外的治疗。5.4%的患者平均住院时间延长了5.5天，8.11%导致再次入院。其中大多数（91.9%）未导致任何失能。每100名床位患者日不良事件发生率最高的科室为：重症监护病房（21.4）、妇产科（7）和内科/外科病房（6）。结论：这是我国一家私立医院进行的第一项研究，使我们能够确定不良事件的发生率、总体发生率、各科室发生率、严重程度、可预防性和因果因素。
