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Prevalence of Adverse Events in Mexico Using the Institute for Healthcare Improvement-Global Trigger Tool Method: A
Luis Meave Gutierrez-Mendoza1,2, Elizabeth Manias3,4, Patricia Nicholson1
1School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.
Rationale:
Globally, adverse events (AEs) are a major contributor to mortality, often arising from healthcare management rather than patients' underlying conditions.
Aims And Objectives:
This study aimed to estimate the prevalence of AEs in three different hospitals in central-north Mexico using the Institute for Healthcare Improvement Global Trigger Tool (IHI-GTT) method.
Method:
A retrospective review of hospital discharges (July 2022 to June 2023) was conducted in three hospitals using the IHI-GTT method. Records of patients aged ≥ 18 years with hospital stays longer than 24 h were reviewed, with obstetric and paediatrics cases excluded. One experienced physician performed the two-stages review process, with inter-rater reliability assessed on 1% of records. Logistic regression analysis was used to identify factors associated with AEs.
Results:
Among 3354 discharges, 36.6% (n = 1227) experienced at least one adverse event (AE), corresponding to 72.79 AEs per 1000 patient-days or 53.04 AEs per 100 admissions. Of these, 72.8% (n = 893) were preventable. The most frequent AEs were medication errors (23.6%), intravenous line errors (23.5%), hospital acquired infections (16.4%), and surgical (9.9%). The AEs contributed to the death of the patient in 14.6% (n = 179) of cases. Risk factors for AEs included hospital transfers (OR: 1.53; 95% CI: 1.25-1.87, p < 0.001), age ≥ 60 years (OR: 1.49; 95% CI: 1.22-1.83, p < 0.001), comorbidities (OR: 1.15; 95% CI: 1.08-1.23, p < 0.001), and longer hospital stay (OR: 1.13; 95% CI: 1.11-1.14, p < 0.001). Elective admissions showed a protective effect (OR: 0.77; 95% CI: 0.62-0.97, p = 0.027).
Conclusion:
The prevalence of AEs in Mexico, a middle-income country, is higher than previously reported. These finding underscore a pressing public health challenge requiring targeted interventions.
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