The incidence of serious adverse events in a tunisian hospital: a retrospective medical record review study

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Published Jan 28, 2016
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Vol. 93 No. 12 (2015): Issue Dec 2015

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Marwène Grira
Thara Larbi
Amira El Ouni
Kamel Bouslama
Meya Abdallah
Ali Harmel
Salwa Hamzaoui
Skander M'rad

Abstract

SUMMARY
Aim : To describe the epidemiology of serious adverse events (SAE) reported in the division of internal medicine at the Mongi Slim university hospital in Tunis, to analyze their causes and contributing factors and compare them to that reported in literature so as to establish prevention strategies when these events were deemed preventable.
Methods This retrospective study collected the medical records of randomly selected 500 index hospitalizations. Records review was conducted in two stages: a primary review that aimed to detect hospitalizations where a SAE was likely to have occurred then a secondary review which purpose was to confirm the presence of the SAE, to determine its nature and its preventability.
Results : SAE were detected in 5.2% of hospitalizations with a preventability of 57.7%. These events were responsible for a prolongation in 27.0% of hospitalizations and disability in 15.4% of cases. They were the cause of admission in 42.9% of hospitalizations in which a SAE occurred. The SAE consisted in adverse drug events in 73.0% of cases, healthcare-associated infections in 19.0% of cases, non-surgical procedures in 4% of cases and pressure ulcers in 4.0% of cases. Age and number of comorbidities were identified as the main risk factors for the occurrence of SAE.
Conclusion : Awareness of the extent and severity of the problem of iatrogenesis is necessary because it is a prerequisite to establishing a culture of patient safety among caregivers.

Keywords:

Serious adverse events; iatrogenesis; patient safety; medical errors; healthcare-associated infections; adverse drug events.

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