Article
Prevalence, preventability, type and severity of nursing-sensitive events in German hospitals: a multicenter longitudinal observational study
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Published: | September 30, 2022 |
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Background and state of (inter)national research: Nursing-sensitive events (NSEs) are common and have been found in international studies to occur in hospitalized patient up to 77% of all adverse events. NSEs may or may not be harmful and contribute to the suffering of patients. Additionally, they constitute an economic burden on hospitals for generating high costs through a prolonged length of stay and additional medical procedures. Data about NSEs in Germany are lacking.
Research question and objective: To determine prevalence, preventability, type and severity of NSEs.
Method or hypothesis: This study is part of TAILR.DE (Nursing-sensiTive events and the Association with Individual patient Levels nuRse staffing in German hospitals”). TAILR.DE is a 3-year multicenter, longitudinal observational study and including four German hospitals. To assess NSEs, standardized retrospective record reviews are used. Between January 2022 and June 2022 the hospital specific 16 weeks observation period takes place. In total, 960 patient records will be reviewed and included. Until the conference, all 960 records will be analyzed.
Results: At the time of the abstract submission, 91 records were reviewed and consisted of 43 (47%) male and 48 (53%) female patients with a mean age of 67,7 years (SD= 16.1). In 60 records (66%) 107 NSEs (range 1-13) were identified of which 101 (94%) were deemed preventable. This corresponds to 116,3 events per 100 admissions and 194,5 events per 1,000 patient days. The most common types of NSEs were deficiency in drug management (n=22, 21%), skin, vessel or tissue harm (n=20, 19%), gastro-intestinal impairment (n=13, 12%) and cardiovascular deterioration (n=10, 9%).
The majority of NSEs (52%, n=56) contributed to or resulted in temporary harm. Additional three NSEs (3%) contributed to or resulted in temporary harm that prolonged index hospitalization, required additional inpatient admission(s) or extra outpatient care. Forty-six (43%) of the NSEs were no-harm incidents. Sixty-nine NSEs (64%) were related to acts of omission, 16 events (15%) to acts of commission and for 22 events (21%) it was not apparent from the record.
Discussion: TAILR.DE is the first study to assess and characterize NSEs in German hospitals based on record reviews. Preliminary data show that NSEs were common, contributed to or resulted in temporary harm and often were preventable. The prevention and reduction of NSEs should be on the safety agenda for German hospitals in order to reduce negative consequences for patients and to decrease the economic burden.
Practical implications: NSE detection is a key measure to ensure high quality of care. The relatively high rates of NSEs make the reduction a high priority.
Appeal for practice (science and/or care) in one sentence: The study describes NSEs in German hospitals, which can trigger quality improvement processes.
Funding: BMBF-Strukturförderung Versorgungsforschung/Nachwuchs; 01GY2001