Instruments and Warning Signs for Identifying and Evaluating the Frequency of Adverse Events in Intermediate and Long-Term Care Centres: A Narrative Systematic Review

被引:0
作者
Malgrat-Caballero, S. [1 ,2 ,3 ]
Kannukene, A. [4 ]
Orrego, C. [5 ,6 ,7 ]
机构
[1] Parc Sanitari Pere Virgili, Ctr Atencio Intermedia, Barcelona, Spain
[2] Vall dHebron Res Inst, Res Grp Aging Frailty & Care Transit Barcelona, REFiT BCN, Barcelona, Spain
[3] Univ Vic, Univ Cent Catalunya, Programa Doctorat Interuniv Cures Integrals Serv S, Vic, Spain
[4] Univ Tartu, L Puusepa 8, EE-50406 Tartu, Estonia
[5] Avedis Donabedian Res Inst FAD, Barcelona 08037, Spain
[6] Univ Autonoma Barcelona UAB, Fac Med, Barcelona 08025, Spain
[7] Network Res Chron Primary Care & Hlth Promot RICAP, Barcelona, Spain
关键词
Long-term care; Nursing home; Intermediate care; Adverse event; Detection tool; Patient safety; NURSING-HOME RESIDENTS; HEALTH OUTCOMES; ASSESSMENT-TOOL; OLDER-ADULTS; FALL RISK; DRUG-USE; PREVALENCE; DEMENTIA; DELIRIUM; SAFETY;
D O I
10.1016/j.jhqr.2024.06.004
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Introduction: There is a lack of data about adverse events (AE) in intermediate and long-term care centers (ILCC). We aimed to synthesize the available scientific evidence on instruments used to identify and characterize AEs. We also aimed to describe the most common adverse events in ILCCs. Material and methods: A narrative systematic review of the literature was conducted according to Prisma recommendations. The PubMed database was searched for articles published between 2000 and 2021. Two reviewers independently screened and reviewed the studies through blind and independent review. We evaluated bias risk with Cochrane's risk of bias tool. Disagreements were resolved by consensus. Discrepancies that were not resolved by discussion were discussed with a third reviewer. Descriptive data was extracted and qualitative content analysis was performed. Results: We found 2191 articles. Based on the inclusion and exclusion criteria, 272 papers were screened by title and abstract, and 66 studies were selected for full review. The instruments used to identify AEs were mostly tools to identify specific AEs or risks of AEs (94%), the remaining 6% were multidimensional. The most frequent categories detected medication-related AEs (n = 26, 40%); falls (n = 7, 11%); psychiatric AEs (6.9%); malnutrition (4.6%), and infections (4.6%). The studies that used multidimensional tools refer to frailty, dependency, or lack of energy as predictors of AEs. However, they do not take into account the importance of detecting AEs. We found 2-11 adverse drug events (ADE) per resident/month. We found a prevalence of falls (12.5%), delirium (9.6-89%), pain (68%), malnutrition (2-83%), and pressure ulcers (3-30%). Urinary tract infections, lower respiratory tract infections, skin and soft tissue infections, and gastroenteritis were the most common infections in this setting. Transitions between different care settings (from hospitals to ILCC and vice versa) expose AE risk. Conclusion: There are many instruments to detect AEs in ILCC, and most have a specific approach. Adverse events affect a significant proportion of patients in ILCC, the nurse-sensitive outcomes, nosocomial infections, and adverse drug events are among the most common. The systematic review was registered with Prospero, ID: CRD42022348168. (c) 2024 FECA. Published by Elsevier Espana, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
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页码:315 / 326
页数:12
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