Ami Hommel1, Martin Magnéli2, Bodil Samuelsson3, Kristina Schildmeijer4, Desirée Sjöstrand5, Katarina E Göransson6, Maria Unbeck7. 1. Department of Care Science, Faculty of Health and Society, Malmö University, SE-205 06 Malmö, Sweden; Department of Orthopaedics, Skåne University Hospital, 221 85 Lund, Sweden. Electronic address: ami.hommel@mah.se. 2. Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, SE-182 88 Stockholm, Sweden; Department of Orthopedics, Danderyd Hospital, SE-182 88 Stockholm, Sweden. 3. Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, SE-182 88 Stockholm, Sweden; Trauma and Reparative Medicine Theme, Karolinska University Hospital, SE-171 79 Stockholm, Sweden. 4. School of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, SE-391 82 Kalmar, Sweden. 5. Education Unit, Skånevård Kryh, Region Skåne, SE-291 89 Kristianstad, Sweden. 6. Department of Medicine, Solna, Karolinska Institutet, SE-171 77 Stockholm, Sweden; Functional Area of Emergency Medicine Solna, Karolinska University Hospital, SE-171 79 Stockholm, Sweden. 7. Trauma and Reparative Medicine Theme, Karolinska University Hospital, SE-171 79 Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
Abstract
BACKGROUND: For decades, patient safety has been recognized as a critical global healthcare issue. However, there is a gap of knowledge of all types of adverse events sensitive to nursing care within hospitals in general and within orthopaedic care specifically. OBJECTIVES: The aim of this study is to explore the incidence and nature of nursing-sensitive adverse events following elective or acute hip arthroplasty at a national level. DESIGN: A retrospective multicenter cohort study. OUTCOME VARIABLES: Nursing-sensitive adverse events, preventability, severity and length of stay. METHODS: All patients, 18 years or older, who had undergone an elective (degenerative joint disease) or acute (fractures) hemi or total hip arthroplasty surgery at 24 hospitals were eligible for inclusion. Retrospective reviews of weighted samples of 1998 randomly selected patient records were carried out using the Swedish version of the Global Trigger Tool. The patients were followed for readmissions up to 90 days postoperatively throughout the whole country regardless of index hospital. RESULTS: A total of 1150 nursing-sensitive adverse events were identified in 728 (36.4%) of patient records, and 943 (82.0%) of the adverse events were judged preventable in the study cohort. The adjusted cumulative incidence regarding nursing-sensitive adverse events for the study population was 18.8%. The most common nursing-sensitive adverse event types were different kinds of healthcare-associated infections (40.9%) and pressure ulcers (16.5%). Significantly higher proportions of nursing-sensitive adverse events were found among female patients compared to male, p < 0.001, and patients with acute admissions compared to elective patients, p < 0.001. Almost half (48.5%) of the adverse events were temporary and of a less severe nature. On the other hand, 592 adverse events were estimated to have contributed to 3351 extra hospital days. CONCLUSIONS: This study shows the magnitude of nursing-sensitive adverse events. We found that nursing-sensitive adverse events were common, in most cases deemed preventable and were associated with different kinds of adverse events and levels of severity in orthopaedic care. Registered nurses play a vital role within the interdisciplinary team as they are the largest group of healthcare professionals, work 24/7 and spend much time at the bedside with patients. Therefore, nursing leadership at all hospital levels must assume responsibility for patient safety and authorize bedside registered nurses to deliver high-quality and sustainable care to patients.
BACKGROUND: For decades, patient safety has been recognized as a critical global healthcare issue. However, there is a gap of knowledge of all types of adverse events sensitive to nursing care within hospitals in general and within orthopaedic care specifically. OBJECTIVES: The aim of this study is to explore the incidence and nature of nursing-sensitive adverse events following elective or acute hip arthroplasty at a national level. DESIGN: A retrospective multicenter cohort study. OUTCOME VARIABLES: Nursing-sensitive adverse events, preventability, severity and length of stay. METHODS: All patients, 18 years or older, who had undergone an elective (degenerative joint disease) or acute (fractures) hemi or total hip arthroplasty surgery at 24 hospitals were eligible for inclusion. Retrospective reviews of weighted samples of 1998 randomly selected patient records were carried out using the Swedish version of the Global Trigger Tool. The patients were followed for readmissions up to 90 days postoperatively throughout the whole country regardless of index hospital. RESULTS: A total of 1150 nursing-sensitive adverse events were identified in 728 (36.4%) of patient records, and 943 (82.0%) of the adverse events were judged preventable in the study cohort. The adjusted cumulative incidence regarding nursing-sensitive adverse events for the study population was 18.8%. The most common nursing-sensitive adverse event types were different kinds of healthcare-associated infections (40.9%) and pressure ulcers (16.5%). Significantly higher proportions of nursing-sensitive adverse events were found among female patients compared to male, p < 0.001, and patients with acute admissions compared to elective patients, p < 0.001. Almost half (48.5%) of the adverse events were temporary and of a less severe nature. On the other hand, 592 adverse events were estimated to have contributed to 3351 extra hospital days. CONCLUSIONS: This study shows the magnitude of nursing-sensitive adverse events. We found that nursing-sensitive adverse events were common, in most cases deemed preventable and were associated with different kinds of adverse events and levels of severity in orthopaedic care. Registered nurses play a vital role within the interdisciplinary team as they are the largest group of healthcare professionals, work 24/7 and spend much time at the bedside with patients. Therefore, nursing leadership at all hospital levels must assume responsibility for patient safety and authorize bedside registered nurses to deliver high-quality and sustainable care to patients.
Authors: Luisa C Eggenschwiler; Anne W S Rutjes; Sarah N Musy; Dietmar Ausserhofer; Natascha M Nielen; René Schwendimann; Maria Unbeck; Michael Simon Journal: PLoS One Date: 2022-09-01 Impact factor: 3.752
Authors: Bartosch Nowak; René Schwendimann; Philippe Lyrer; Leo H Bonati; Gian Marco De Marchis; Nils Peters; Franziska Zúñiga; Lili Saar; Maria Unbeck; Michael Simon Journal: Int J Environ Res Public Health Date: 2022-02-27 Impact factor: 3.390