Gerber Anne, Da Silva Lopes André, Szüts Natacha, Simon Michael, Ribordy-Baudat Viviane, Ebneter Andreas, Perrinjaquet Claire, Gaignard Marie-Estelle, Nicodet Delphine, Betticher Daniel, Bula Grégoire, Cote Maxime, Duchosal Michel André, Berret Pierre-André, Dietrich Pierre-Yves, Brennan Caitlin, Decosterd Sandy, Ferreira Nobre Sandrina, Peters Solange, Koelliker Reto, Ninane Françoise, Jeitziner Marie-Madlen, Colomer-Lahiguera Sara, Eicher Manuela
School of Health Sciences (HESAV) University of Applied Sciences and Arts Western Switzerland (HES-SO) Lausanne Switzerland.
Institute of Higher Education and Research in Healthcare (IUFRS) Faculty of Biology and Medicine, University of Lausanne Lausanne Switzerland.
Health Sci Rep. 2020 May 12;3(2):e160. doi: 10.1002/hsr2.160. eCollection 2020 Jun.
The occurrence rate of adverse events (AEs) related to care among hospitalized oncology patients in Switzerland remains unknown. The primary objective of this study was to describe, for the first time, the occurrence rate, type, severity of harm, and preventability of AEs related to care, reported in health records of hospitalized hematological and solid-tumor cancer patients in three Swiss hospitals.
Using an adapted version of the validated Global Trigger Tool (GTT) from the Institute for Healthcare Improvement, we conducted a retrospective record review of patients discharged from oncology units over a 6-week period during 2018. Our convenience sample included all records from adult patients (≥18 years of age), diagnosed with cancer, and hospitalized (>24 hours). Per the GTT method, two trained nurses independently assessed patient records to identify AEs using triggers, and physicians from the included units analyzed the consensus of the two nurses. Together, they assessed the severity and preventability of each AE.
From the sample of 224 reviewed records, we identified 661 triggers and 169 AEs in 94 of them (42%). Pain related to care was the most frequent AE (n = 29), followed by constipation (n = 17). AEs rates were 75.4 per 100 admissions and 106.6 per 1000 patient days. Most of the identified AEs (78%) caused temporary harm to the patient and required an intervention. Among AEs during hospitalization (n = 125), 76 (61%) were considered not preventable, 28 (22%) preventable, and 21 (17%) undetermined.
About half of the hospitalized oncology patients suffered from at least one AE related to care during their hospitalization. Pain, constipation, and nosocomial infections were the most frequent AEs. It is, therefore, essential to identify AEs to guide future clinical practice initiatives to ensure patient safety.
瑞士住院肿瘤患者中与护理相关的不良事件（AE）发生率尚不清楚。本研究的主要目的是首次描述瑞士三家医院住院血液肿瘤和实体肿瘤癌症患者健康记录中报告的与护理相关的不良事件的发生率、类型、伤害严重程度和可预防性。
我们使用了医疗改进研究所经过验证的全球触发工具（GTT）的改编版本，对2018年6周内从肿瘤科出院的患者进行了回顾性记录审查。我们的便利样本包括所有成年患者（≥18岁）的记录，这些患者被诊断患有癌症并住院（>24小时）。根据GTT方法，两名经过培训的护士独立评估患者记录以使用触发因素识别不良事件，纳入科室的医生分析两名护士的共识。他们共同评估了每个不良事件的严重程度和可预防性。
在224份审查记录的样本中，我们识别出661个触发因素，其中94份记录（42%）中有169例不良事件。与护理相关的疼痛是最常见的不良事件（n = 29），其次是便秘（n = 17）。不良事件发生率为每100次入院75.4例，每1000个患者日106.6例。大多数已识别的不良事件（78%）对患者造成了暂时伤害，需要进行干预。在住院期间的不良事件（n = 125）中，76例（61%）被认为不可预防，28例（22%）可预防，21例（17%）未确定。
约一半的住院肿瘤患者在住院期间至少遭受了一次与护理相关的不良事件。疼痛、便秘和医院感染是最常见의不良事件。因此，识别不良事件对于指导未来的临床实践举措以确保患者安全至关重要。
