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High risk of adverse events in hospitalised hip fracture patients of 65 years and older: results of a retrospective record review study.

Abstract：

OBJECTIVES:Hip fracture patients of 65 years and older are a complex patient group who often suffer from complications and difficult rehabilitation with disappointing results. It is unknown to what extent suboptimal hospital care contributes to these poor outcomes. This study reports on the scale, preventability, causes and prevention strategies of adverse events in patients, aged 65 years and older, admitted to the hospital with a primary diagnosis of hip fracture. DESIGN, SETTING AND OUTCOME MEASURES:A retrospective record review study was conducted of 616 hip fracture patients (≥65 years) admitted to surgical or orthopaedic departments in four Dutch hospitals in 2007. Experienced physician reviewers determined the presence and preventability of adverse events, causes and prevention strategies using a structured review form. The main outcome measures were frequency of adverse events and preventable adverse events in hospitalised hip fracture patients of 65 years and older, and strategies to prevent them in the future. RESULTS:114 (19%) of the 616 patients in the study experienced one or more adverse events; 49 of these were preventable. The majority of the adverse events (70%) was related to the surgical procedure and many resulted in an intervention or additional treatment (67%). Human causes contributed to 53% of the adverse events, followed by patient-related factors (39%). Training and close monitoring of quality of care and the health professional's performance were the most often selected strategies to prevent these adverse events in the future. CONCLUSIONS:The high percentage of preventable adverse events found in this study shows that care for older hospitalised hip fracture patients should be improved. More training and quality assurance is required to provide safer care and to reduce the number of preventable adverse events in this vulnerable patient group.

journal_name

BMJ Open

journal_title

BMJ open

authors

Merten H,Johannesma PC,Lubberding S,Zegers M,Langelaan M,Jukema GN,Heetveld MJ,Wagner C

doi

10.1136/bmjopen-2014-006663

subject

Has Abstract

pub_date

2015-09-07 00:00:00

pages

e006663

issue

issn

2044-6055

pii

bmjopen-2014-006663

journal_volume

pub_type

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High risk of adverse events in hospitalised hip fracture patients of 65 years and older: results of a retrospective record review study.