gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Patient safety: Is there a role of guidelines?

Meeting Abstract

  • S. Van Dulmen - Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  • M. Tacken - Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  • R. Nijhuis- van der Sanden - Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP061

doi: 10.3205/12gin173, urn:nbn:de:0183-12gin1731

Veröffentlicht: 10. Juli 2012

© 2012 Van Dulmen et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Background: Patient safety is of great importance. Research on patient safety in allied primary healthcare is scarce.

Objective: To document patient safety in primary allied healthcare in the Netherlands and to identify factors associated with incidents.

Method: A retrospective study of 1000 patient records in a representative sample of 20 allied healthcare practices. The selected incidents were analyzed using PRISMA medical (Prevention and Recovery Information System for Monitoring and Analysis) to identify underlying root causes. Factors associated with incidents were examined in a logistic regression analysis.

Results: In 18 of 1000 (1.8%) cases an incident was found in Physiotherapy, exercise and occupational therapy practices. Incidents were related to problems in diagnosis, adequate intervention selection and monitoring. The probability of occurring of incidents was higher if more care providers had been involved in therapy and if patient records were incomplete (37% of the records).

Discussion: The absolute number of incidents was low but the incompleteness of the patient records may cause an underestimation. Not only the detection and assessment of incidents leads to difficulties, but a poor documentation is actually a source of unsafe care and hinders good transfer of care and raises the risk of incidents. Moreover, many patients were not treated according to guidelines and lack on clinical reasoning was crucial.

Implications for guideline developers/users: Guidelines with a focus on clinical reasoning and good reporting are needed to further enhance patient safety and quality of care.