Characteristics of Patient Safety Incident Occurrences Reported by Japanese Homecare Nurses: A Prospective Observational Study.

Natsuki Yamamoto-Takiguchi,Mahiro Fujisaki-Sueda-Sakai,Takashi Naruse,Noriko Yamamoto-Mitani

doi:10.3390/nursrep11040090

Natsuki Yamamoto-Takiguchi, Mahiro Fujisaki-Sueda-Sakai + Show 2 more

Open Access

https://doi.org/10.3390/nursrep11040090

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Abstract

Patient safety incidents (PSIs) prevention is important in healthcare because PSIs affect patients negatively and increase medical costs and resource use. However, PSI knowledge in homecare is limited. To analyze patient safety issues and strategies, we aimed to identify the characteristics and contexts of PSI occurrences in homecare settings. A prospective observational study was conducted between July and November 2017 at 27 Japanese homecare nurse (HCN) agencies. HCNs at each agency voluntarily completed PSI reports indicating whether they contributed to PSIs or were informed of a PSI by the client/informal caregiver/other care provider during a period of three months. A total of 139 PSIs were analyzed, with the most common being falls (43.9%), followed by medication errors (25.2%). Among the PSIs reported to the HCN agencies, 44 were recorded on formal incident report forms, whereas 95 were reported as PSIs that required a response (e.g., injury care) but were not recorded on formal incident report forms. Most PSIs that occurred when no HCN was visiting were not recorded as incident reports (82.1%). Developing a framework/system that can accumulate, analyze, and share information on PSIs that occur in the absence of HCNs may provide insights into PSIs experienced by HCN clients.

Highlights

The aging and deinstitutionalization of the Japanese population have led to a rapid increase in the demand for homecare services [1]; homecare nursing (HCN) services, with approximately 580,000 clients in Japan [2], play an important role in homecare
The most common Patient safety incidents (PSIs) experienced by clients of HCN services were falls, followed by medication errors
Despite collecting PSIs using the same definition, PSIs included those that were recorded on formal incident report forms and those that were not

Summary

Introduction

The aging and deinstitutionalization of the Japanese population have led to a rapid increase in the demand for homecare services [1]; homecare nursing (HCN) services, with approximately 580,000 clients in Japan [2], play an important role in homecare. In Japan, potential clients can apply with an HCN agency through their primary care physician or directly, and if their physician recognizes that an HCN service is required, they will issue an “Order for visiting nursing.”. As service demands increase rapidly, the maintenance and improvement of the quality of these services have become important issues in Japanese homecare. Patient safety is an essential factor contributing to the quality of healthcare services [5], and patient safety has been well studied in acute care hospitals [6]. Since PSIs can affect both the activities of daily living (ADL) and the quality of life of patients (clients) and may lead to an increase in medical costs and resource use [8,9], preventing PSIs in healthcare settings is essential

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