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Revista Argentina de Salud Pública
versão impressa ISSN 1852-8724versão On-line ISSN 1853-810X
Resumo
MORALES, Elba Mirta; GEROMETTA, Rosana María del Rosario; CIALZETA, Jorge Raúl e RIVERO, Mabel Itatí. Adverse event identification and analysis on pregnant women treated in a level IIIB hospital. Rev. argent. salud pública [online]. 2020, vol.12, pp.10-10. Epub 08-Ago-2020. ISSN 1852-8724.
INTRODUCTION
Incidents are errors and involuntary faults. When they cause harm to the patient during health care, they are called adverse events (AE). The general objective was to describe the AE of pregnant inpatients. More specifically, the study aimed at determining the incidence, estimating the impact on hospitalization days and severity, describing the causes related to diagnosis, procedures and administration of medicines, and analyzing the proportion of AE in pregnant women with severe maternal morbidity (SMM).
METHODS
An observational, descriptive and prospective design was used with women admitted during pregnancy, delivery and postpartum between July and December 2018. Injuries/complications were identified through a screening form; in positive cases, medical records were evaluated with a modular survey to identify AE and other variables.
RESULTS
A total of 1914 women were included; there were 98 with one or more positive criteria; 42 had an AE (2.19%; 95%CI: 1.58-2.95). There was an increase of hospitalization days in 18 cases, with 19 (45.2%) moderate and 19 (45.2%) severe AE, 24 (57%) diagnostic errors, 24 (57%) of procedure, 11 (26%) related to medications, and 75% of the AE related to SMM.
DISCUSSION
The incidence of AE was low, but with a high percentage of serious events. The number of additional hospitalization days was low. Diagnostic and procedural errors occurred in more than 50% of the events, with fewer medication errors. Two out of three patients with SMM suffered an AE.
Palavras-chave : Adverse events; Patient safety; Pregnancy.