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Medición de la incidencia de eventos adversos atribuidos a la atención sanitaria en un Departamento de Pediatría de un hospital universitario / Measurement of the incidence of care-associated adverse events at the Department of Pediatrics of a teaching hospital
Fajreldines, Ana; Schnitzler, Eduardo; Torres, Silvio; Panattieri, Néstor; Pellizzari, Marcelo.
  • Fajreldines, Ana; Hospital Austral. Dpto. de Calidad y Seguridad del Paciente. Unidad de Investigación. Pilar. AR
  • Schnitzler, Eduardo; Hospital Austral. Departamento de Desarrollo Académico. Pilar. AR
  • Torres, Silvio; Hospital Austral. Unidad de Cuidados Intensivos Pediátricos. Pilar. AR
  • Panattieri, Néstor; Hospital Austral. Servicio de Pediatría General. Pilar. AR
  • Pellizzari, Marcelo; Hospital Austral. Dpto. de Calidad y Seguridad del Paciente. Unidad de Investigación. Pilar. AR
Arch. argent. pediatr ; 117(2): 106-109, abr. 2019. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1001164
RESUMEN
Introducción. Los eventos adversos pueden ser detectados por diversas herramientas de pesquisa. En la población pediátrica, la Pediatric Global Trigger Tool busca gatillos en la historia clínica para detectar daño asociado al cuidado, tanto prevenible como no prevenible. Objetivo. Medir la incidencia de eventos adversos en el Departamento de Pediatría utilizando dicha herramienta. Conocer los tipos de eventos y las variables asociadas. Población y métodos. Estudio de incidencia, de corte longitudinal. Resultados. Se estudiaron 318 pacientes; media de edad 2,99 años (rango 0-17); porcentaje de mujeres 164 (el 51,57 %). Se halló un 11 % de eventos por cada 100 admisiones, 15,5 eventos cada 1000 días-paciente. Los eventos más frecuentes fueron asociados a medicación el 48,57 % (n = 17); a bacteriología (infecciones) el 42,85 % (n = 15); y a cuidados el 8,57 % (n = 3). Diecinueve eventos fueron leves (el 54,28 %), 14 (el 40 %) prolongaron la hospitalización (moderados) y 2 (el 5,71 %) requirieron soporte vital (graves). Se hallaron 168 gatillos, 0,53 gatillos por paciente, 74,4 gatillos cada 1000 días-paciente y 4,8 gatillos por cada evento adverso. En el análisis de regresión logística multivariada, las variables asociadas a la aparición de los eventos adversos fueron medicamentos de alto riesgo, sexo femenino, peso, número de transferencias dentro del hospital y estancia superior a 5 días. Conclusiones. La utilización de la Pediatric Global Trigger Tool permite identificar eventos adversos en pacientes pediátricos hospitalizados y ayudar a encauzar acciones de mejora, de acuerdo con las variables asociadas.
ABSTRACT
Introduction. Adverse events may be detected using different screening tools. In the pediatric population, the Pediatric Trigger Tool looks for triggers in the medical record to detect preventable and non-preventable care-associated harm. Objective. To measure the incidence of adverse events at the Department of Pediatrics using this tool. To know the types of events and associated outcome measures. Population and methods. Longitudinal cohort study. Results. A total of 318 patients were included; mean age 2.99 years (range 0-17); 164 (51.57 %) were girls. There were 11 % of events per 100 admissions, 15.5 events per 1000patient-days. The most common events were associated with medication use 48.57 % (n = 17); bacteriology (infections) 42.85 % (n = 15); and care 8.57 % (n = 3). Nineteen events were mild (54.28 %), 14 (40 %) extended the length of stay (moderate), and 2 (5.71 %) required vital support (severe). A total of 168 triggers were detected; 0.53 triggers per patient, 74.4 triggers per 1000 patient-days, and 4.8 triggers per adverse event. In the multivariate logistic regression analysis, the outcome measures associated with the development of adverse events were high-risk medications, female sex, weight, number of transfers within the hospital, and length of stay longer than 5 days. Conclusions. Using the Pediatric Trigger Tool helped to identify adverse events in hospitalized pediatric patients and guide improvement measures based on associated outcome measures.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Primary Health Care / Child, Hospitalized / Quality Indicators, Health Care / Drug-Related Side Effects and Adverse Reactions Type of study: Incidence study / Observational study / Prognostic study / Risk factors / Screening study Limits: Adolescent / Child / Child, preschool / Humans / Infant / Infant, Newborn Language: English / Spanish Journal: Arch. argent. pediatr Journal subject: Pediatrics Year: 2019 Type: Article Affiliation country: Argentina Institution/Affiliation country: Hospital Austral/AR

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Full text: Available Index: LILACS (Americas) Main subject: Primary Health Care / Child, Hospitalized / Quality Indicators, Health Care / Drug-Related Side Effects and Adverse Reactions Type of study: Incidence study / Observational study / Prognostic study / Risk factors / Screening study Limits: Adolescent / Child / Child, preschool / Humans / Infant / Infant, Newborn Language: English / Spanish Journal: Arch. argent. pediatr Journal subject: Pediatrics Year: 2019 Type: Article Affiliation country: Argentina Institution/Affiliation country: Hospital Austral/AR