Evaluación de la incidencia y de la posibilidad de evitar eventos adversos en hospitales: una revisión integradora

Zanetti, Ariane Cristina Barboza; Gabriel, Carmen Silvia; Dias, Bruna Moreno; Bernardes, Andrea; Moura, André Almeida de; Gabriel, Andréia Boldrini; Lima Júnior, Antônio José de

Acessibilidade / Reportar erro

Brasil

Revista Gaúcha de Enfermagem

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Sumário

Integrative Review • Rev. Gaúcha Enferm. 41 • 2020 • https://doi.org/10.1590/1983-1447.2020.20190364 copiar

Evaluación de la incidencia y de la posibilidad de evitar eventos adversos en hospitales: una revisión integradora

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Destacar la producción científica relacionada con la adopción de la revisión retrospectiva de registros médicos para evaluar la incidencia y la posibilidad de evitar eventos adversos en los hospitales.

Método:

Revisión integradora en las bases de datos MEDLINE, LILACS, SCOPUS, Web of Science y EMBASE realizada en mayo de 2019 con la siguiente pregunta guía: ¿Qué se conoce sobre la adopción de métodos de revisión retrospectiva de registros de pacientes internados para evaluar la incidencia y la posibilidad de evitar eventos adversos en los hospitales? Seguidamente se realizó la categorización, síntesis y clasificación de los niveles de evidencia de las publicaciones incluidas.

Resultados:

Entre 13 estudios seleccionados, los instrumentos adoptados para evaluar la presencia de eventos adversos fueron el Harvard Medical Practice Study, el Canadian Adverse Event Study, el Quality in Australian Health Care Study y la Global Trigger Tool. La incidencia varió de 5,7 a 14,2%, mientras que la posibilidad de evitar eventos adversos varió de 31 a 83%.

Conclusión:

Se encontraron diferencias en la incidencia y la posibilidad de evitar eventos adversos, con heterogeneidad en la calidad de la atención brindada, la información registrada en las historias clínicas, los criterios de detección utilizados, y las evaluaciones de los revisores.

Palabras clave:
Seguridad del paciente; Errores médicos; Hospitales; Estudios retrospectivos

Study/Evidence level	Country, year of publication, number of charts sampled, and period of the retrospective review	Instruments to assess AEs in hospitals	Results
1919. Sari AB, Sheldon TA, Cracknell A, Turnbull A, Dobson Y, Grant C, et al. Extent, nature and consequences of adverse events: results of a retrospective casenote review in a large NHS hospital. Qual Saf Heal Care. 2007;16(6):434-9. doi: https://doi.org/10.1136/qshc.2006.021154 https://doi.org/10.1136/qshc.2006.021154... / VI	England, 2007 - 1,006 medical records of hospitalized patients between January and May 2004	Assessment instruments developed by the Harvard Medical Practice Study (HMPS)	AE incidence = 8.7% Preventable AEs = 31%
2020. Aranaz-Andres JM, Aibar-Remon C, Vitaller-Murillo J, Ruiz-Lopez P, Limon-Ramirez R, Terol-Garcia E, et al. Incidence of adverse events related to health care in Spain: results of the Spanish National Study of Adverse Events. J Epidemiol Community Heal. 2008;62(12):1022-9. doi: https://doi.org/10.1136/jech.2007.065227 https://doi.org/10.1136/jech.2007.065227... / IV	Spain, 2008 - 5,624 records of patients discharged between June 4^th and June 10^th, 2005	Assessment instruments developed by the HMPS	AE incidence = 8.4% Preventable AEs = 42.6%
⁽2121. Mendes W, Martins M, Rozenfeld S, Travassos C. The assessment of adverse events in hospitals in Brazil. Int J Qual Heal Care. 2009;21(4):279-84. doi: https://doi.org/10.1093/intqhc/mzp022 https://doi.org/10.1093/intqhc/mzp022... / IV	Brazil, 2009 - 1,103 medical records of patients admitted during 2003	Assessment instruments developed by the Canadian Adverse Events Study (CAES)*	AE incidence = 7.6% Preventable AEs = 66.7%
2222. Zegers M, de Bruijne MC, Wagner C, Hoonhout LHF, Waaijman R, Smits M, et al. Adverse events and potentially preventable deaths in Dutch hospitals: results of a retrospective patient record review study. Qual Saf Heal Care. 2009;18(4):297-302. doi: https://doi.org/10.1136/qshc.2007.025924 https://doi.org/10.1136/qshc.2007.025924... / VI	Netherlands, 2009 - 7,926 records of patients admitted in 2004	Assessment instruments developed by the CAES*	AE incidence = 5.7% Preventable AEs = 39.6%
2323. Letaief M, El Mhamdi S, El-Asady R, Siddiqi S, Abdullatif A. Adverse events in a Tunisian hospital: results of a retrospective cohort study. Int J Qual Heal Care. 2010;22(5):380-5. doi: https://doi.org/10.1093/intqhc/mzq040 https://doi.org/10.1093/intqhc/mzq040... / IV	Tunisia, 2010 - 620 medical records of patients admitted in 2005	Assessment instruments developed by the HMPS	AE incidence = 10% 117. Preventable AEs = 60%
2424. Lucas-Imbernón FJ, Aranaz-Andrés JM, Gea-Velázquez de Castro MT, Gallardo-Martínez D, Limón-Ramírez R, García-Fernández C. Plan de seguridad clínica del Complejo Hospitalario Universitario de Albacete (CHUA). Diagnóstico inicial: estudio de eventos adversos. Rev Calid Asist. 2012;27(4):189-96. doi: https://doi.org/10.1016/j.cali.2011.10.005 https://doi.org/10.1016/j.cali.2011.10.0... / IV	Spain, 2012 - 1,143 medical records of patients discharged between November 5^th and November 19^th, 2006	Assessment instruments developed by the HMPS	AE incidence = 6.8% Preventable AEs = 63.3%
2525. Wilson RM, Michel P, Olsen S, Gibberd RW, Vincent C, El-Assady R, et al. Patient safety in developing countries: retrospective estimation of scale and nature of harm to patients in hospital. BMJ. 2012;344:e832. doi: https://doi.org/10.1136/bmj.e832 https://doi.org/10.1136/bmj.e832... / VI	Egypt, Jordan, Kenya, Morocco, South Africa, Sudan, Tunisia, and Yemen, 2012 - 15,548 medical records of patients admitted in 2005	Assessment instruments developed by the Quality in Australian Health Care Study (QAHCS)*	AE incidence = 8.2% Preventable AEs = 83%
2626. Najjar S, Hamdan M, Euwema MC, Vleugels A, Sermeus W, Massoud R, et al. The Global Trigger Tool shows that one out of seven patients suffers harm in Palestinian hospitals: challenges for launching a strategic safety plan. Int J Qual Heal Care. 2013;25(6):6407. doi: https://doi.org/10.1093/intqhc/mzt066 https://doi.org/10.1093/intqhc/mzt066... / VI	Palestine, 2013 - 640 medical records of patients discharged between May and August 2009	Global Trigger Tool proposed by the Institute for Healthcare Improvement (IHI-GTT)	AE incidence = 14.2% Preventable AEs = 59.3%
⁽2727. Lancis-Sepúlveda ML, Asenjo-Araya C. Estudio de incidencia de eventos adversos en una clínica privada en Chile. Rev Calid Asist. 2014;29(2):78-83. doi: https://doi.org/10.1016/j.cali.2013.10.003 https://doi.org/10.1016/j.cali.2013.10.0... / IV	Chile, 2014 - 500 records of patients discharged between January 16^th and January 31^st, 2012	Assessment instruments developed by the HMPS	AE incidence = 6.2% 141. Preventable AEs = 67.6%
2828. Bañeres J, Orrego C, Navarro L, Casas L, Banqué M, Suñol R. Epidemiología de los eventos adversos hospitalarios en Catalunya: un primer paso para la mejora de la seguridad del paciente. Med Clin (Barc). 2014;143(Supl 1):3-10. doi: https://doi.org/10.1016/j.medcli.2014.07.005 https://doi.org/10.1016/j.medcli.2014.07... / IV	Spain, 2014 - 4,790 medical records of patients discharged in 2004	Assessment instruments created based on HMPS, CAES and QAHCS	AE incidence = 7.4% 147. Preventable AEs = 43.5%
2929. Sousa P, Uva AS, Serranheira F, Nunes C, Leite ES. Estimating the incidence of adverse events in Portuguese hospitals: a contribution to improving quality and patient safety. BMC Health Serv Res. 2014;14(1):311. doi: https://doi.org/10.1186/1472-6963-14-311 https://doi.org/10.1186/1472-6963-14-311... / IV	Portugal, 2014 - 1,669 medical records of patients admitted between January 1^st and December 31^st, 2009	Assessment instruments created based on HMPS, CAES and QAHCS	AE incidence = 11.1% Preventable AEs = 53.2%
3030. Sari AA, Doshmangir L, Torabi F, Rashidian A, Sedaghat M, Ghomi R, et al. The incidence, nature and consequences of adverse events in Iranian hospitals. Arch Iran Med. 2015 [cited 2019 May 15];18(12):811-5. Available from: Available from: http://www.ams.ac.ir/AIM/NEWPUB/15/18/12/004.pdf http://www.ams.ac.ir/AIM/NEWPUB/15/18/12... / VI	Iran, 2015 - 1,162 medical records of patients admitted between April and September 2012	Assessment instruments created based on HMPS, CAES and QAHCS	AE incidence = 7.3% Preventable AEs = 34.3%
3131. Rafter N, Hickey A, Conroy RM, Condell S, O’connor P, Vaughan D, et al. The Irish National Adverse Events Study (INAES): the frequency and nature of adverse events in Irish hospitals: a retrospective record review study. BMJ Qual Saf. 2017;26(2):111-9. doi: https://doi.org/10.1136/bmjqs-2015-004828 https://doi.org/10.1136/bmjqs-2015-00482... / VI	Ireland, 2017 - 1,574 medical records of patients admitted in 2009	Assessment instruments developed by the CAES*	AE incidence = 10.3% 165. Preventable AEs = 72.7%

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[1] Corresponding author:
Ariane Cristina Barboza Zanetti E-mail: arianezanetti@usp.br