Patient safety events during pediatric hospitalizations.
OBJECTIVE: Our objective was to describe potential patient safety events for hospitalized children, using the patient safety indicators (PSIs), and examine associations with these events. METHODS: PSI algorithms, developed by researchers at the Agency for Healthcare Research and Quality to identify...
| Publicado en: | Pediatrics Vol. 111; no. 6; pp. 1358 - 1367 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
American Academy of Pediatrics
Jun2003 Part 1 of 3
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106623454&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106623454 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00314005 PDT jtl: Pediatrics issn: 00314005 maglogo: N pubinfo: dt: Jun2003 Part 1 of 3 vid: 111 iid: 6 pid: 1659 pub: American Academy of Pediatrics place: Elk Grove Village, Illinois artinfo: ui: 106623454 106623454 2005076363 10.1542/peds.111.6.1358 NLM12777553 106623454 ppf: 1358 ppct: 9 formats: tig: atl: Patient safety events during pediatric hospitalizations. aug: au: Miller MR Elixhauser A Zhan C affil: Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality, Rockville, Maryland; mmille21@jhmi.edu sug: subj: Adverse Health Care Event Prevention and Control Child Safety Child, Hospitalized Adolescence Adult Algorithms Birth Injuries Epidemiology Child Child, Preschool Clinical Indicators Clinical Indicators Economics Comparative Studies Diagnosis-Related Groups Diagnosis-Related Groups Economics Funding Source Hospital Mortality Trends Hospitals, Pediatric Economics Infant Infant, Newborn Inpatients International Classification of Diseases Length of Stay Length of Stay Economics Logistic Regression Multivariate Analysis Record Review Safety Economics Treatment Errors Human Adolescent: 13-18 years Adult: 19-44 years Child: 6-12 years Child, Preschool: 2-5 years Infant: 1-23 months Infant, Newborn: birth-1 month ab: OBJECTIVE: Our objective was to describe potential patient safety events for hospitalized children, using the patient safety indicators (PSIs), and examine associations with these events. METHODS: PSI algorithms, developed by researchers at the Agency for Healthcare Research and Quality to identify potential in-hospital patient safety problems using administrative data, were applied to 3.8 million discharge records for children under 19 years from 22 states in the 1997 Healthcare Cost and Utilization Project. Prevalence of PSI events and associations with patient-level and hospital-level characteristics, length of stay, in-hospital mortality, and total charges were examined. RESULTS: The prevalence of pediatric patient safety events is significant with the highest rate found for birth trauma at 1.5 cases per every 100 births. The majority of these events for birth trauma consist of long bone and skull fractures, excluding the clavicle. Compared with records without PSI events, discharges with PSI events had 2- to 6-fold longer lengths of stay, 2- to 18-fold higher rates of in-hospital mortality, and 2- to 20-fold higher total charges. Bivariate and multivariate analyses found that all PSI events except birth trauma were directly associated with factors related to greater severity of illness and large urban teaching institutions. Birth trauma, however, was directly associated with black and Hispanic ethnicity but was not consistently associated with technologically sophisticated teaching institutions. CONCLUSIONS: The prevalence of birth trauma and other potential patient safety events for hospitalized children is high and comparable to hospitalized adults. These events are associated with increased length of stay, in-hospital mortality, and total charges. Associated factors differ significantly for birth trauma compared with other PSI events. Institutional application of the PSIs may be useful to identify processes of care that warrant further evaluation as the health care industry tackles the problem of patient safety, particularly for children. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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