Patient safety and adverse events related with obstetric care
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To determine the frequency and distribution of Adverse Events (AE) in obstetrics departments at Spanish hospitals.
We present a retrospective cohort study including 816 women admitted to the obstetrics departments at 41 hospitals that took part in the National Adverse Effects Study in Spain (ENEAS) and an extension of this study in all hospitals located in two Autonomous Regions. To identify AE, nurses from each participating hospital examined all medical records, and completed a validated screening guide. A team of external reviewers evaluated the medical records of all women who met at least one of the criteria in the screening guide to verify all AE. The main outcome measure was the incidence of AE during hospitalization.
The cumulative incidence of patients with obstetric care-related AE was 3.6 % (95 % CI 2.3–4.8). The most frequent AE were those related with surgical interventions or procedures (59.4 %). None of the AE detected were considered severe. 36.7 % of the AE lengthened the woman’s hospital stay, and 13.3 % led to hospital admission. Additional procedures were needed after 71.9 % of the AE, and additional treatment was needed after 59.4 %. 56.3 % of the AE were considered preventable.
Obstetric care is characterized by generally younger ages among patients, their low frequency of comorbidities and high expectations for successful outcomes of care. However, some factors can increase obstetric risk and favor the appearance of preventable incidents and AE. Systems are needed to detect preventable AE, and measures are needed to reduce risks or attenuate their consequences.
KeywordsPatient safety Delivery Pregnancy
This work was supported by the Ministry of Health of Spain.
Conflict of interest
The authors declare no conflicts of interest in connection with this article.
- 1.Kohn L, Corrigan JM, Donaldson MS (eds) (1999) To err is human; building a safer health system. National Academy Press, WashingtonGoogle Scholar
- 4.Michel P, Minodier C, Lathelize M, Moty-Monnereau C, Domecq S, Chaleix M et al (2010) Les événements indésirables graves associés aux soins observés dans les établissements de santé Résultats des enquêtes nationales menées en 2009 et 2004. Dossiers Solidarité et Santé 17:1–18Google Scholar
- 7.Wilson RM, Michel P, Olsen S, Gibberd RW El-Assady R, Rasslan O et al (2012) Patient safety in developing countries: retrospective estimation of scale and nature of harm to patients in hospital. BMJ 344: e832. doi: 10.1136/bmj.e832. Available at: http://www.bmj.com/content/344/bmj.e832. Accessed 7 Jan 2014
- 10.Aibar C, Júdez D (2005) Estudio autonómico de efectos adversos. ENEAS Aragon. Informe técnico no 1. Servicio Aragonés de Salud, ZaragozaGoogle Scholar
- 11.Moris J (2008) Estudio de los efectos adversos en la atención hospitalaria en el Principado de Asturias. Consejería de Salud y Servicios Sanitarios. Gobierno del Principado de Asturias, OviedoGoogle Scholar
- 12.Aranaz JM y el Grupo de Estudio del Proyecto IDEA (2004) Proyecto IDEA: Identificación de efectos adversos. Rev Calidad Asistencial 19: 14–8. Available at: http://proyectoidea.com/index2.htm. Accessed 7 Jan 2014
- 13.World Health Organization (2009) More than words. Conceptual framework for the international classification for patient safety. Technical report. WHO. Available at: http://www.who.int/patientsafety/implementation/taxonomy/icps_technical_report_en.pdf. Accessed 7 Jan 2014
- 14.Tormo MJ, Dal-Ré R, Pérez-Albarracín G (1998) Ética e Investigación. In: Principios, aplicaciones y casos prácticos sobre la revisión de los aspectos éticos de la investigación epidemiológica. Barcelona: Sociedad Española de EpidemiologíaGoogle Scholar
- 18.King’s Fund (2008) Safe births: everybody’s business. An independent inquiry into the safety of maternity services in England. In: Walker I, Grise E (eds) King’s Fund, LondonGoogle Scholar
- 19.Joint Commission (2004) Preventing infant death and injury during delivery. Sentinel Event Alert Issue 30. Available at: http://www.jointcommission.org/assets/1/18/SEA_30.PDF. Accessed 7 Jan 2014
- 21.Millar J, Mattke S and the Members of the OECD Patient Safety Panel (2004) Selecting indicators for patient safety at the health systems level in OECD countries. OECD health technical papers no. 18. ParisGoogle Scholar
- 22.Institute for Healthcare Improvement (2006) Perinatal trigger tool. Available at: http://www.ihi.org/knowledge/Pages/Tools/PerinatalTriggerTool.aspx. Accessed 7 Jan 2014