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Adverse events in orthopedic care identified via the Global Trigger Tool in Sweden - implications on preventable prolonged hospitalizations

Rutberg, Hans; Borgstedt-Risberg, Madeleine; Gustafson, Pelle LU and Unbeck, Maria (2016) In Patient Safety in Surgery 10(1).
Abstract

Background: The national incidence of adverse events (AEs) in Swedish orthopedic care has never been described. A new national database has made it possible to describe incidence, nature, preventability and consequences of AEs in Swedish orthopedic care. Methods: We used national data from a structured two-stage record review with a Swedish modification of the Global Trigger Tool. The sample was 4,994 randomly selected orthopedic admissions in 56 hospitals during 2013 and 2014. The AEs were classified according to the Swedish Patient Safety Act into preventable or non-preventable. Results: At least one AE occurred in 733 (15%, 95% CI 13.7-15.7) admissions. Of 950 identified AEs, 697 (73%) were judged preventable. More than half of the... (More)

Background: The national incidence of adverse events (AEs) in Swedish orthopedic care has never been described. A new national database has made it possible to describe incidence, nature, preventability and consequences of AEs in Swedish orthopedic care. Methods: We used national data from a structured two-stage record review with a Swedish modification of the Global Trigger Tool. The sample was 4,994 randomly selected orthopedic admissions in 56 hospitals during 2013 and 2014. The AEs were classified according to the Swedish Patient Safety Act into preventable or non-preventable. Results: At least one AE occurred in 733 (15%, 95% CI 13.7-15.7) admissions. Of 950 identified AEs, 697 (73%) were judged preventable. More than half of the AEs (54%) were of temporary nature. The most common types of AE were healthcare-associated infections and distended urinary bladder. Patients ≥65years had more AEs (p<0.001), and were more often affected by pressure ulcer (p<0.001) and urinary tract infections (p<0.01). Distended urinary bladder was seen more frequently in patients aged 18-64 years (p=0.01). Length of stay was twice as long for patients with AEs (p<0.001). We estimate 232,000 extra hospital days due to AEs during these 2years. The pattern of AEs in orthopedic care was different compared to other hospital specialties. Conclusions: Using a national database, we found AEs in 15% of orthopedic admissions. The majority of the AEs was of temporary nature and judged preventable. Our results can be used to guide focused patient safety work.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adverse event, Global Trigger Tool, Orthopedic care, Patient safety, Retrospective record review
in
Patient Safety in Surgery
volume
10
issue
1
publisher
BioMed Central
external identifiers
  • scopus:84992390394
  • wos:000395265300002
ISSN
1754-9493
DOI
10.1186/s13037-016-0112-y
language
English
LU publication?
yes
id
88ae5123-b8d3-4ebe-a1e9-f8be2f926730
date added to LUP
2016-11-08 15:01:19
date last changed
2017-09-18 11:29:39
@article{88ae5123-b8d3-4ebe-a1e9-f8be2f926730,
  abstract     = {<p>Background: The national incidence of adverse events (AEs) in Swedish orthopedic care has never been described. A new national database has made it possible to describe incidence, nature, preventability and consequences of AEs in Swedish orthopedic care. Methods: We used national data from a structured two-stage record review with a Swedish modification of the Global Trigger Tool. The sample was 4,994 randomly selected orthopedic admissions in 56 hospitals during 2013 and 2014. The AEs were classified according to the Swedish Patient Safety Act into preventable or non-preventable. Results: At least one AE occurred in 733 (15%, 95% CI 13.7-15.7) admissions. Of 950 identified AEs, 697 (73%) were judged preventable. More than half of the AEs (54%) were of temporary nature. The most common types of AE were healthcare-associated infections and distended urinary bladder. Patients ≥65years had more AEs (p&lt;0.001), and were more often affected by pressure ulcer (p&lt;0.001) and urinary tract infections (p&lt;0.01). Distended urinary bladder was seen more frequently in patients aged 18-64 years (p=0.01). Length of stay was twice as long for patients with AEs (p&lt;0.001). We estimate 232,000 extra hospital days due to AEs during these 2years. The pattern of AEs in orthopedic care was different compared to other hospital specialties. Conclusions: Using a national database, we found AEs in 15% of orthopedic admissions. The majority of the AEs was of temporary nature and judged preventable. Our results can be used to guide focused patient safety work.</p>},
  articleno    = {23},
  author       = {Rutberg, Hans and Borgstedt-Risberg, Madeleine and Gustafson, Pelle and Unbeck, Maria},
  issn         = {1754-9493},
  keyword      = {Adverse event,Global Trigger Tool,Orthopedic care,Patient safety,Retrospective record review},
  language     = {eng},
  month        = {10},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {Patient Safety in Surgery},
  title        = {Adverse events in orthopedic care identified via the Global Trigger Tool in Sweden - implications on preventable prolonged hospitalizations},
  url          = {http://dx.doi.org/10.1186/s13037-016-0112-y},
  volume       = {10},
  year         = {2016},
}