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Factors contributing to serious adverse events in nursing homes

Author

Listed:
  • Åsa Andersson
  • Catharina Frank
  • Ania ML Willman
  • Per‐Olof Sandman
  • Görel Hansebo

Abstract

Aims and objectives To identify the most common serious adverse events that occurred in nursing homes and their most frequent contributing factors to the improvement of safe nursing care. Background There is a need to improve safe nursing care in nursing homes. Residents are often frail and vulnerable with extensive needs for nursing care. A relatively minor adverse event in nursing care can cause serious injury that could have been preventable. Design This was a retrospective study, with a total sample of data regarding adverse events (n = 173) in nursing homes, concerning nursing care reported by healthcare providers in Sweden to the Health and Social Care Inspectorate. The reports were analysed with content analysis, and the frequencies of the adverse events, and their contributing factors, were described with descriptive statistics. Results Medication errors, falls, delayed or inappropriate intervention and missed nursing care contributed to the vast majority (89%) of the serious adverse events. A total of 693 possible contributing factors were identified. The most common contributing factors were (i) lack of competence, (ii) incomplete or lack of documentation, (iii) teamwork failure and (iv) inadequate communication. Conclusions The contributing factors frequently interacted yet they varied between different groups of serious adverse events. The resident's safety depends on the availability of staff's competence as well as adequate documentation about the resident's condition. Lack of competence was underestimated by healthcare providers. Relevance to clinical practice Registered nurses and assistant nurses need to have awareness of contributing factors to adverse events in nursing care. A holistic approach to improve patient safety in nursing homes requires competence of the staff, safe environments as well as resident's and relative's participation.

Suggested Citation

  • Åsa Andersson & Catharina Frank & Ania ML Willman & Per‐Olof Sandman & Görel Hansebo, 2018. "Factors contributing to serious adverse events in nursing homes," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(1-2), pages 354-362, January.
  • Handle: RePEc:wly:jocnur:v:27:y:2018:i:1-2:p:e354-e362
    DOI: 10.1111/jocn.13914
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    References listed on IDEAS

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    1. Koen De Meester & Peter Van Bogaert & Sean P Clarke & Leo Bossaert, 2013. "In‐hospital mortality after serious adverse events on medical and surgical nursing units: a mixed methods study," Journal of Clinical Nursing, John Wiley & Sons, vol. 22(15-16), pages 2308-2317, August.
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    Cited by:

    1. Isabel Gonçalves & Diana Arvelos Mendes & Sílvia Caldeira & Élvio Jesus & Elisabete Nunes, 2023. "The Primary Nursing Care Model and Inpatients’ Nursing-Sensitive Outcomes: A Systematic Review and Narrative Synthesis of Quantitative Studies," IJERPH, MDPI, vol. 20(3), pages 1-19, January.
    2. Owain David Williams, 2020. "COVID-19 and Private Health: Market and Governance Failure," Development, Palgrave Macmillan;Society for International Deveopment, vol. 63(2), pages 181-190, December.
    3. Young-Rim Choi & Dai-Young Kwon & Sung-Ok Chang, 2021. "The Development and Effectiveness of a Web-Based Emergency Management Educational Program for Long-Term Care Facility Interprofessional Practitioners," IJERPH, MDPI, vol. 18(23), pages 1-12, December.
    4. Patricia M. Davidson & Sarah L. Szanton, 2020. "Nursing homes and COVID‐19: We can and should do better," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(15-16), pages 2758-2759, August.

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