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Exploring nursing-s...
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Nilsson, LenaLinköpings universitet,Avdelningen för omvårdnad och reproduktiv hälsa,Medicinska fakulteten,Region Östergötland, ANOPIVA US
(author)
Exploring nursing-sensitive events in home healthcare : A national multicenter cohort study using a trigger tool
- Article/chapterEnglish2023
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Elsevier,2023
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LIBRIS-ID:oai:DiVA.org:lnu-119564
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https://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-119564URI
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https://doi.org/10.1016/j.ijnurstu.2022.104434DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:du-45142URI
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https://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-4511URI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:151900790URI
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-192198URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Funding Agencies|Medical Research Council of Southeast Sweden (FORSS) [470161, LiO-537211]
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BACKGROUND: The provision of home healthcare is increasing in response to the growing aging population with the need for chronic disease management in their homes. Safety work differs from hospital care. The incidence of adverse events in home healthcare is sparsely studied but is estimated to occur in-one third of patients, and most are deemed preventable. Although nursing care is crucial for risk assessment and preventive work in the home environment, the role of registered nurses in the prevention of no-harm incidents and adverse events has not received sufficient scientific attention.OBJECTIVES: To explore nursing-sensitive events in patients receiving home healthcare.DESIGN, SETTING AND PARTICIPANTS: A Swedish national multicenter study based on a structured record review of 600 randomly chosen healthcare records from 10 organizations in different regions of the country.METHODS: Ten trained teams, each including physician(s) and registered nurses, undertook a review based on the Global Trigger Tool method. The review covered a maximum of 90 days from admission to home healthcare. First, each record was screened for the presence of 38 predefined triggers. In the second step, every potential event was assessed according to preventability, types of events, severity, time of occurrence, consequences of the event, and potential contributing causes.RESULTS: In total, 699 events were identified in the study. Of these, 495 (74.0%) were classified as nursing-sensitive (227 no-harm incidents and 268 adverse events) and affected 267 (44.5%) patients, with a mean of 1.9 events per patient. The majority (n = 367, 73.1%) were considered preventable. The most prominent types of nursing-sensitive event were falls (n = 138, 27.9%), pressure ulcers (n = 62, 12.5%), healthcare-associated infections (n = 58, 11.7%) and medication management (n = 50, 10.1%). Concerning severity, 45.9% were classified as no-harm incidents and another 36.6% resulted in temporary harm that required extra healthcare resources: 226 hospital days, 66 physician visits in outpatient care, and 99 in home healthcare. All severity types occurred from day 1, except death, which included only one patient. The most frequent contributing factors were deficiencies in nursing care, treatment & diagnosis, with the subgroups nursing care, observation, treatment & follow-up, followed by deficiencies in the organization.CONCLUSIONS: Nursing-sensitive events in home healthcare are common, often preventable, and occur from the start of the care period. This study contributes to increased knowledge of patient safety shortcomings and points to the important role that registered nurses play in patient safety work.
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Lindblad, MarléneRöda Korsets Högskola,Hälsovetenskapliga institutionen,Swedish Red Cross Univ, Sweden
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Johansson, NathalieHögskolan Dalarna,Institutionen för hälsa och välfärd,Region Uppsala,Dalarna University, Sweden; Örsundsbro Health Center, Sweden,Dalarna Univ, Sweden; Orsundsbro Hlth Ctr, Sweden
(author)
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Säfström, LisaHögskolan Dalarna,Institutionen för hälsa och välfärd,Dalarna University, Sweden; Heby Home Health Care, Sweden,Dalarna Univ, Sweden; Heby Home Hlth Care, Sweden
(author)
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Schildmeijer, Kristina,1959-Linnéuniversitetet,Institutionen för hälso- och vårdvetenskap (HV),Linnaeus University, Kalmar,Linnaeus University, Sweden,Linnaeus Univ, Sweden(Swepub:lnu)esckr
(author)
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Ekstedt, Mirjam,ProfessorKarolinska Institutet,Linnéuniversitetet,Institutionen för hälso- och vårdvetenskap (HV),Region Uppsala, Sweden,Reaction,Linnaeus University, Kalmar; Karolinska Institutet, Stockholm,Linnaeus University, Sweden; Karolinska Institutet, Sweden,Linnaeus Univ, Sweden; Karolinska Inst, Sweden(Swepub:lnu)miekaa
(author)
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Unbeck, MariaHögskolan Dalarna,Omvårdnad,Karolinska Institutet, Stockholm,Dalarna University, Sweden; Karolinska Institutet, Sweden,Dalarna Univ, Sweden; Karolinska Inst, Sweden(Swepub:du)mun
(author)
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Linköpings universitetAvdelningen för omvårdnad och reproduktiv hälsa
(creator_code:org_t)
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In:International Journal of Nursing Studies: Elsevier1380020-74891873-491X
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