Occurrence of No-Harm Incidents and Adverse Events in Hospitalized Patients with Ischemic Stroke or TIA: A Cohort Study Using Trigger Tool Methodology

Bartosch Nowak, René Schwendimann, Philippe Lyrer, Leo H. Bonati, Gian Marco De Marchis, Nils Peters, Franziska Zúñiga, Lili Saar, Maria Unbeck and Michael Simon
Additional contact information
Bartosch Nowak: Department Head Organs, Spine- and Neuromedicine, University Hospital Basel, 4031 Basel, Switzerland
René Schwendimann: Patient Safety Office, University Hospital Basel, 4031 Basel, Switzerland
Philippe Lyrer: Department of Neurology and Stroke Center, University Hospital and University of Basel, 4031 Basel, Switzerland
Leo H. Bonati: Department of Neurology and Stroke Center, University Hospital and University of Basel, 4031 Basel, Switzerland
Gian Marco De Marchis: Department of Neurology and Stroke Center, University Hospital and University of Basel, 4031 Basel, Switzerland
Nils Peters: Department of Neurology and Stroke Center, University Hospital and University of Basel, 4031 Basel, Switzerland
Franziska Zúñiga: Institute of Nursing Science, University of Basel, 4031 Basel, Switzerland
Lili Saar: Department of Neurology, Universitätsklinik Freiburg, 79106 Freiburg im Breisgau, Germany
Maria Unbeck: School of Health and Welfare, Dalarna University, 79131 Falun, Sweden
Michael Simon: Institute of Nursing Science, University of Basel, 4031 Basel, Switzerland

IJERPH, 2022, vol. 19, issue 5, 1-10

Abstract: Adverse events (AEs)—healthcare caused events leading to patient harm or even death—are common in healthcare. Although it is a frequently investigated topic, systematic knowledge on this phenomenon in stroke patients is limited. To determine cumulative incidence of no-harm incidents and AEs, including their severity and preventability, a cohort study using trigger tool methodology for retrospective record review was designed. The study was carried out in a stroke center at a university hospital in the German speaking part of Switzerland. Electronic records from 150 randomly selected patient admissions for transient ischemic attack (TIA) or ischemic stroke, with or without acute recanalization therapy, were used. In total, 170 events (108 AEs and 62 no-harm incidents) were identified, affecting 83 patients (55.3%; 95% CI 47 to 63.4), corresponding to an event rate of 113 events/100 admissions or 142 events/1000 patient days. The three most frequent AEs were ischemic strokes ( n = 12, 7.1%), urinary tract infections ( n = 11, 6.5%) and phlebitis ( n = 10, 5.9%). The most frequent no-harm incidents were medication events ( n = 37, 21.8%). Preventability ranged from 12.5% for allergic reactions to 100% for medication events and pressure ulcers. Most of the events found (142; 83.5%; 95% CI 76.9 to 88.6) occurred throughout the whole stroke care. The remaining 28 events (16.5%; 95% CI 11.4 to 23.1) were detected during stroke care but were related to care outside the stroke pathway. Trigger tool methodology allows detection of AEs and no-harm incidents, showing a frequent occurrence of both event types in stroke and TIA patients. Further investigations into events’ relationships with organizational systems and processes will be needed, first to achieve a better understanding of these events’ underlying mechanisms and risk factors, then to determine efforts needed to improve patient safety.

Keywords: adverse events; no-harm incidents; retrospective record review; stroke; trigger tool methodology (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/19/5/2796/pdf (application/pdf)
https://www.mdpi.com/1660-4601/19/5/2796/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2022:i:5:p:2796-:d:760211

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().