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Health care safety incidents in paediatric emergency care
Dolores Beteta Fernández1, Ana Miriam Seva Llor2, Laura Martínez Alarcón1
1Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.
Insights
Patient safety incidents occurred in 12.3% of children in paediatric emergency departments (PEDs), with most being preventable. These safety events highlight areas for improvement in healthcare delivery and medication practices.
Area of Science:
- Pediatric Emergency Medicine
- Patient Safety
- Healthcare Quality Improvement
Background:
- Patient safety incidents are a significant concern in healthcare settings.
- Paediatric emergency departments (PEDs) face unique challenges in ensuring patient safety.
- Understanding the scope and causes of incidents is crucial for developing effective interventions.
Purpose of the Study:
- To characterize the frequency, sources, root causes, and consequences of safety incidents in paediatric emergency departments (PEDs).
- To identify specific areas within PEDs where safety improvements are most needed.
Main Methods:
- A cross-sectional, observational, and descriptive study was conducted in a paediatric emergency department.
- Data were collected through direct observation during care delivery and a follow-up telephone survey.
- Methodology was adapted from established patient safety studies (ERIDA, ENEAS, EVADUR).
Main Results:
- A total of 204 cases were analyzed, with a safety incident incidence of 12.3% (25 cases).
- Most incidents (82.1%) reached the patient and caused harm, with common root causes including healthcare delivery and medication.
- A high proportion (78.6%) of incidents were deemed preventable, with 50% attributed to failures in healthcare delivery.
Conclusions:
- Safety incidents impact a notable percentage of children in paediatric emergency departments.
- The majority of these incidents are preventable, emphasizing the need for targeted quality improvement initiatives.
- Focusing on healthcare delivery and medication practices can significantly enhance patient safety in PEDs.
Objective:
To characterize safety incidents in paediatric emergency departments (PEDs): frequency, sources, root causes, and consequences.
Materials And Methods:
We conducted a cross-sectional, observational and descriptive study in the PED of the Clinical University Hospital XX (blinded for review). Patients were recruited through opportunity sampling and the data were collected during care delivery and one week later through a telephone survey. The methodology was based on the ERIDA study on patient safety incidents related to emergency care, which in turn was based on the ENEAS and EVADUR studies.
Results:
The study included a total of 204 cases. At least one incident was detected in 25 cases, with two incidents detected in 3 cases, for a total incidence of 12.3%. Twelve incidents were detected during care delivery and the rest during the telephone call. Ten percent did not reach the patient, 7.1% reached the patient but caused no harm, and 82.1% reached the patient and caused harm. Thirteen incidents (46.4%) did not have an impact on care delivery, 8 (28.6%) required a new visit or referral, 6 (21.4%) required additional observation and 1 (3.6%) medical or surgical treatment. The most frequent root causes were health care delivery and medication. Incidents related to procedures and medication were most frequent. Of all incidents, 78.6% were considered preventable, with 50% identified as clear failures in health care delivery.
Conclusions:
Safety incidents affected 12.3% of children managed in the PED of the HCUVA, of which 78.6% were preventable.
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