Patient Safety Events Among Children Receiving Home Health Care.

Area of Science:

• Pediatric Home Health Care Safety
• Patient Safety Events
• Health Care Quality Improvement

Background:

• Children with medical complexity require complex home care, but safety issues in this setting are under-researched.
• Systems-level approaches to patient safety in pediatric home health care (HHC) are still developing.
• Quantifying and categorizing HHC staff incidents is essential for preventing safety events.

Purpose of the Study:

• To determine the rates and types of patient safety events in a national US pediatric population receiving HHC.
• To identify common causes and impacts of safety events in pediatric home care.

Main Methods:

• Retrospective cohort study analyzing staff incident reports from a pediatric HHC agency across 11 US states (September 2022 - August 2023).
• Included patients under 21 years receiving HHC (excluding psychiatric care).
• Analyzed patient safety events per 1000 HHC-days, classifying errors using the NCC MERP Index.

Main Results:

• 307 of 678 incidents (45.3%) were patient safety events among 348 children (11.9%).
• The rate was 0.68 patient safety events per 1000 HHC-days, with medication (38.8%) and implanted device (32.7%) errors being most frequent.
• Harmful errors involved skin injuries and falls; approximately half required additional monitoring or emergency care.

Conclusions:

• Over 10% of children receiving HHC experienced reported incidents, with nearly half being patient safety events.
• This study provides crucial data on pediatric HHC safety, identifying key areas like medication and device safety.
• Further research should investigate contributing factors, prevention strategies, and incorporate parental perspectives.