Hospital incident records

Several instruments have been developed to assess hospital staff s perceptions of aspects of workplace safety culture and a number of studies have reported associations between hospital safety culture and safety outcome measures (Jackson et al. 2010). Profiling the hospital safety culture scores is relatively straightforward but finding safety outcome measures for patients or workers is more challenging (Flin 2007). Different types of safety outcome data can be collected, e.g. (i) hospital incident records for staff or patients or clinical data for patients, (ii) self-reports of incidents and injuries by workers or patients and (iii) workers safety behaviours (self-reported or observed). 

Racially, white patients account for 61% of all drug-related hospital visits in the United States, followed by black (26%) and Hispanics (11%). With the exception of rohypnol, the 69-80% of all club drug incidents recorded by Drug Abuse Warning Network (DAWN) involve white, non-Hispanic patients—a fairly typical reflection of the U.S. population. A far larger share (56%) of rohypnol mentions are attributed to Hispanic patients, but this may have to do with the small sample size available to researchers. 

Minor injuries or illnesses requiring treatment by a doctor A frequency of minor injuries or illnesses Injury resulting in restricted activity or job reassignment Any injury that prevents return to work Injury requiring hospitalization OSHA recordable incident OSHA reportable incident... 

You do not have to report every fatality or multiple hospitalization incident resulting from a motor vehicle accident. If the motor vehicle accident occurs on a public street or highway and does not occur in a construction work zone, you do not have to report the incident to OSHA. However, these injuries must be recorded on yom- OSHA injury and illness records, if you are required to keep them. 

OSHA does not require that you call to report a fatality or multiple hospitalization incident if it involves a commercial airplane, train, subway, or bus accident. Fatahties or multiple hospitalization incidents that occur on a commercial or public transportation system must be recorded on yorxr OSHA injury and Ulness records, if you are required to keep them. 

When medicines are on the market, the actual incidence of serious ADRs is difficult to judge but clearly they occur with sufficient frequency to be a serious concern. An authoritative review7 concludes that between 1 in 30 and 1 in 60 physician consultations result from ADRs (representing 1 in 30 to 40 patients). The same review concludes that 4 to 6% of hospital admissions could be the result of ADRs. Although there is debate over the number of deaths caused by ADRs — the figure of around 106,000 deaths per year in the USA is often quoted,2 8 this has been suggested to be a gross overestimate and, for example, the U.S. FDA MedWatch system recorded 6894 deaths in 2000 (http //www.fda.gov/medwatch/ index.html). 

Hospital data collected by the Substance Abuse and Mental Health Services Administration, a division of the U.S. Department of Health and Human Services, suggests the age of the typical American club drug user is between 18 and 25. Whereas only 20% of all drug-related emergency room visits involved patients 25 and under, this age group accounts for 58% of ketamine incidents, 67% of all recorded MDMA incidents, 50% of recorded GHB incidents, and 46% of all LSD incidents. 

BaetjgrAM. 1950b. Pulmonary carcinoma in chromate workers II. Incidence and basis of hospital records. Int Arch Ind Hyg Occup Med 2(5) 505-516. 

Cancer, in fact, has afflicted humans around the world and throughout recorded history. The origin of the word cancer is credited to the Greek physician Hippocrates (460-370 Bc), considered the father of medicine. Hippocrates used the terms car-cinos and carcinoma to describe non-ulcer-forming and ulcer-forming tumors. Bernardino Ramazzini, an Italian doctor, reported in 1713 the high incidence of breast cancer in nuns. Percival Pott of Saint Bartholomew s Hospital in London described in 1775 an occupational cancer in chimney sweeps, cancer of the scrotum, caused by soot collection under the scrotum of workers. 

Operations Plan, Job Action Sheets, operational procedures, records, and/or other related items Writing the facility/hospital After Action Report and Improvement Plan Participation in external (conmiunity and governmental) meetings and other postincident discussion and after-action activities Post-incident media briefings and facihty/hospital status updates Post-incident pubUc education and information Stress management activities and services for staff ... 

In a review of the medical records of HIV-positive patients who had taken nevirapine, delavirdine, or both, the frequency of skin reactions was determined, as were the consequences of rechallenge with the same or the alternative agent (17). The overall incidence of rash attributed to the use of one of the non-nucleoside reverse transcriptase inhibitors (NNRTIs) was 37%. While rash due to delavirdine was more common (8/20 versus 25/69), the rash due to nevirapine was more severe and necessitated more frequent hospitalization. Rash recurred in six of eight patients who were rechallenged with the same agent and in seven of 10 who were switched to the alternative agent. The conclusion was drawn that there is little value in attempting to re-treat patients who have had skin reactions to NNRTIs, except possibly those with limited treatment options. 

In a retrospective analysis of the incidence of Guillain-Barre syndrome in Finland in 1981-86 by examination of medical records identified from the nationwide Hospital Discharge Register, based on a population of 5 million people, 247 patients fulfilled the accepted criteria of Guillain-Barre syndrome corresponding to a mean annual incidence of 0.82 per 100 000 (72). Monthly rates... 

Marlowe (2001) cites reports documenting that the incidence of neuropsychiatric illness in U.S. Army troops in Vietnam was, in fact, lower than any recorded in previous conflicts. The rate in Vietnam in calendar years 1965 and 1966 of individuals hospitalized or excused from duty for neuropsychiatric reasons was 12 per 1000 troops per year. The rate during the Korean War was 73 per 1000 troops per year, and in WWII, in combat areas, the rate was as high as 101 per 1000 in the First U.S. Army in Europe. Marlowe suggested several reasons for these improved outcomes. In addition to the rotation policy and sporadic combat, he noted that morale and training were probably better than those in WWH or Korea, as was the functioning of psychiatric teams in close proximity to the combat forces. 

In Austria, the incidence of different subtypes of hyperthyroidism was registered before (retrospective) and after (both retrospective and prospective) the iodization of table salt was increased in the mid-1990s (Mostbeck et aL, 1998). In Austria, thyroid examinations were mostly carried out in nuclear medicine centers, and the registration was based on all patients with newly diagnosed hyperthyroidism referred to one of 19 nuclear medicine departments in the study area. No linkage to other hospital records or contact with GPs was made, to ensure that all patients were referred to hospital and thereby registered in the study. 

USA) 1995. Phase 1 14 days phase 2 5 days paediatric teaching hospital. Phase 1 2 units (ICU and medical surgical unit). Phase 2 3 units (ICU, medical and surgical units) Following medication order written from prescribing through administration. Also review of medical record, pharmacy s clinical interventions and quality control log, and incident reports. Also review of medication administration record Sample 3312 medication orders Error rate 24/100 orders Administration error 0.15% doses administered... 

USA) 1999) teaching hospital and all paediatric wards in a general teaching hospital Identified incidents from reporte, medication order sheets and medication administration records and chart reviews Sample 10 778 medication orders orders Error rate 5.7/100 orders... 

Retrospective reviews of medical records aim to assess the nature, incidence and economic impact of adverse events and to provide some information on their causes. Adverse events are defined as an unintended injury caused by medical management rather than the disease process that results in some definite injury or, at the very least, spent on additional days in hospital (Box 4.1). Definitions are critical in patient safety and one has to be constantly aware of differences in terminology. For instance, a study by Andrews et al. (1997) in the United States showed a 17.7% rate of serious adverse events in a surgical unit, much higher than most other studies. However, their definition of adverse event was different from that usually employed and they used observation rather than record review, as most other studies do. These are not flaws the study is a good one. The point is... 

Schioler, T., Lipczak, H., Pedersen, B.L. et al. (2001) Danish adverse event study. [Incidence of adverse events in hospitals. A retrospective study of medical records]. Ugeskr Laeger, 163(1), 1585-1586. 

Soop, M., Fryksmark, U., Koster, M. and Haglund, B. (2009) The incidence of adverse events in Swedish hospitals a retrospective medical record review study. International Journal for Quality in Health Care, 21(4), 285-291. 

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