Concurrent Incidence of Adverse Events in Hospitals and Nursing Homes

Authors

  • Betsie G.I. Van Gaal PhD, RN,

    Corresponding author
    1. Senior researcher, Scientific Institute for Quality of Healthcare, Radboud university medical center, Nijmegen, the Netherlands
    • Correspondence Betsie G.I. Van Gaal, Radboud university medical center, Scientific Institute for Quality of Healthcare, 114 IQ healthcare, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands. E-mail: Betsie.vangaal@radboudumc.nl

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  • Lisette Schoonhoven PhD, RN,

    1. Senior Research Fellow Nursing Science, Scientific Institute for Quality of Healthcare, Radboud university medical center, Nijmegen, the Netherlands and Faculty of Health Sciences, University of Southampton, Southampton, UK
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  • Joke A.J. Mintjes-de Groot PhD, RN,

    1. Emeritus Professor Critical Care, Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, the Netherlands
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  • Tom Defloor PhD, RN,

    1. Was Professor of Nursing Science, Department of Public Health, Faculty of Medicine and Health Science, Ghent University, Gent, Belgium
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  • Herbert Habets MSc, RN,

    1. Geriatric Clinical Nurse Specialist, Orbis Medical Centre, Sittard-Geleen, Senior Lecturer, Zuyd University of Applied Sciences, Heerlen, The Netherlands
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  • Andreas Voss PhD, MD,

    1. Professor of Clinical Microbiology and Infection Control, Department of Medical Microbiology, Radboud university medical center, Nijmegen, the Netherlands and Consultant Clinical Microbiologist, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands
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  • Theo van Achterberg PhD, RN,

    1. Professor of Nursing Science, Scientific Institute for Quality of Healthcare, Radboud university medical center, Nijmegen, the Netherlands and Center for Health Services and Nursing Research, KU Leuven, Leuven, Belgium
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  • Raymond T.C.M. Koopmans PhD, MD

    1. Professor of Elderly Care Medicine, Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud university medical center, Nijmegen, the Netherlands
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Abstract

Purpose

To describe the concurrent incidence of pressure ulcers, urinary tract infections, and falls in hospitals and nursing homes, and the preventive care given. Additionally, the correlation between the occurrence of these adverse events and preventive care was explored.

Design and Settings

A prospective, 3-month, cohort study at 10 hospitals and 10 nursing homes in the Netherlands.

Participants

687 hospital patients and 241 nursing home patients.

Main Outcome Measures

The incidence of three adverse events and preventive care given to patients at risk. During weekly visits, the patients and their files were assessed. Additionally, observations were performed.

Results

Seventy-seven hospital patients (11%) and 111 nursing home patients (46%) developed one or more adverse events. The incidence rate for both types of patients, and for the three adverse events combined, was 9% adverse events per patient week.

In hospitals, 34% of the patients received adequate pressure ulcer preventive care, while 47% of the patients received adequate urinary tract infection preventive care, and none of the patients received adequate falls preventive care. In nursing homes, 18% of the patients received adequate pressure ulcer preventive care, 42% of the patients received adequate urinary tract infection preventive care, and less than 1% of the patients received adequate falls prevention care.

Negative or no correlations were found between the incidence rates for the three adverse events. In nursing homes the incidence of pressure ulcers and preventive care were positively correlated.

Conclusions

There is a high incidence of adverse events in hospitals and nursing homes. Many patients at risk do not receive adequate preventive care.

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