According to a study published Wednesday in the New England Journal of Medicinm. I in 4 hospitalized patients in the United States will experience harm.
The sobering findings underscore that, despite decades of effort, U.S. hospitals still have a long way to go to improve patient safety, experts say.
“These numbers are disappointing. But not shocking,” said Dr. David Bates, chief of general medicine at Brigham and Women’s Hospital in Boston, who led the study. “They show we still have a lot of work to do.”
The study looked at the medical records of 2,809 patients hospitalized in 2018 at 11 Boston-area hospitals. The study excluded people who were admitted only for observation or for hospice, rehabilitation. Addiction treatment or psychiatric care.
Hospital data showed that 663 patients – about 24% – experienced at least one event during. Their stay that negatively affected their health. Even temporarily.
A total of 222 adverse events were considered preventable, meaning the error resulted in patient harm. This translates to about 7% of the total admissions analyzed by the researchers. Thirty-nine people, or 1% of the total admitted. Experienced serious preventable adverse events that resulted in serious harm
But m They may include known side effects of certain medications or known risks associated with surgery.
Overall the most common adverse events (about 40%) were related to drugs administered in the hospital. Surgery and other procedures accounted for just 30%, followed by what the study authors called “patient-care events,” 15%. These include falls and bedsores, both of which are considered preventable.
One bright spot, experts say, is that hospital-acquired infections account for. About 12% of adverse events — a significant decrease from a 1991. Study that found infections were the second-most common adverse event.
A 1991 study known as the Harvard Medical Practice Study I is considered a landmark study. Using data on patients hospitalized in New York State in 1984, it was found that only 4% of
hospitalized patients experienced harm. However, the study found a smaller range of adverse events than the current study. And hospitals have become much better at reporting harm when it occurs.
“It’s clear that, at least, rates are not going down and that loss continues to be a really serious problem,” Bates said.
Dr. Albert Wu, director of the Center for Health Services. some cases. New risks have emerged due to advances in medicine.
For example, drug companies have made significant progress in the three decades since the last report was published. But with the large number of drugs comes more opportunities for medication errors.
“There are more drugs available today than there were in 1991, and some drugs have a small therapeutic margin. The gap between therapeutic effect and dangerous doses,” Dr. said
Donald Berwick, president emeritus. And a senior fellow at the Institute for Healthcare Improvement in Boston. Berwick wrote an editorial that was published Wednesday alongside the new study.
Even technologies implemented to prevent medication errors can create new opportunities for accidents.
You have to anticipate what can go wrong and build dikes around the dangers,” Berwick said.
Linda Aiken, a professor and founding director of the Center for Health Outcomes. And Policy Research at Penn Nursing in Philadelphia. Said staffing is at the heart of the patient safety problem.
“As we research patient safety, we consistently see that a major explanation for poor patient outcomes. Is inadequate numbers of nurses at the bedside,” she said. “Having an adequate number of nurses is a building block for safety.”
In a 2018 study published in the Journal of Health Affairs, Aiken and her team interviewed nurses at 535 hospitals in the United States. Sixty percent reported that their hospitals did not have enough nurses to provide safe care. The pandemic has already put a strain on nursing staff, leading to strikes.
Only one state, California, has legal standards regarding the minimum number of staff members. Required for hospital safety. A nurse cannot take care of more than five patients at a time.
“If you really implement a standard like this, you could save a lot of lives that you read
