Abstract
BackgroundPatient safety is a key priority of the National Department of Health. Despite the publication of legislation and other measures to address patient safety incidents (PSIs) there are a paucity of studies relating to patient safety at the different levels of hospitals.ObjectivesTo determine the epidemiology (incidence, nature and root causes) of PSIs at a long-term rehabilitative hospital between April 2011 and March 2016.MethodData were collected through a review and analysis of routinely collected hospital information on patient records and from the PSI register, as well as minutes of adverse health events meetings, quality assurance reports and patient complaints register.ResultsA total or 4.12 PSIs per 10 000 inpatient days were reported. Approximately 52% of the adverse health events occurred in females with most of the adverse health events occurring in the 50–59 years category: 96% being reported during the day and 33% within the shift change. Pressure ulcers, falls, injury, hospital acquired infections and medication error were the most commonly reported PSIs. Patient factors were listed as the most common root cause for the PSIs.ConclusionThe study shows a low reporting rate of PSIs whilst showing a diverse pattern of PSIs over a period of 5 years. There is a need for active change management in order to establish a blame-free culture and learning environment to improve reporting of PSI. A comprehensive quality improvement intervention addressing patients, their families and staff is essential to minimise PSI and its consequences.
Highlights
Patient safety incidents (PSIs) continue to be a problem in healthcare delivery with patient harm being ranked the 14th leading cause of morbidity and mortality globally (Jha et al 2013)
Results from developed countries indicate that the rates of PSI were at least 8% of all hospital admissions with more than 50% judged to be preventable and deaths of between 0.5% and 2.0% of patients in hospital are associated with PSI (De Vries et al 2008)
A study conducted amongst gynaecology patients admitted at King Edward Hospital, Durban showed that PSI occurred in 11.7% of admissions and 52% were deemed avoidable (Matsaseng & Moodley 2005)
Summary
Patient safety incidents (PSIs) continue to be a problem in healthcare delivery with patient harm being ranked the 14th leading cause of morbidity and mortality globally (Jha et al 2013). A retrospective review of patients’ hospital records across eight lower-middle income countries (Egypt, Jordan, Kenya, Morocco, Tunisia, Sudan, South Africa and Yemen) estimated the frequency of patient harm at 8.2% with a range of 2.5% to 18.4% per country. Of these events, 83% were judged to be preventable, whilst about 30% were associated with the death of the patient (Wilson et al 2012). A study conducted amongst gynaecology patients admitted at King Edward Hospital, Durban showed that PSI occurred in 11.7% of admissions and 52% were deemed avoidable (Matsaseng & Moodley 2005).
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