incident reporting by acute pain service at a tertiary care university hospital

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ID: 206937
2015
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Abstract
Background and Aims: Provision of effective and safe postoperative pain management is the principal responsibility of acute pain services (APSs). Continuous quality assurance is essential for high-quality patient care. We initiated anonymous reporting of critical incidents by APS to ensure continuous quality improvement and here present prospectively collected data on the reported incidents. Our objective was to analyze the frequency and nature of incidents and to see if any harm was caused to patients. Material and Methods: Data were collected from January 1, 2012 to September 30, 2013. An incident related to pain management was defined as "An incident that occurs in a patient receiving pain management supervised by APS, and causes or has the potential to cause harm or affects patient safety." A form was filled including incident type, personnel involved, any harm caused, and steps taken to rectify it. Frequencies and percentages were computed for categorical variables. Results: A total of 2042 patients were seen and 442 (21.64%) incidents reported during the study period, including documentation errors (136/31%), noncompliance with protocols (113/25.56%), wrong combination of drugs (56/12.66%), premature discontinuation (74/16.72%), prolonged delays in change of syringes (27/6.10%), loss to follow-up (19/4.29%), administration of contraindicated drugs (9/2.03%), catheter pull-outs (6/1.35%), and faulty equipment (2/0.45%). Steps were taken to rectify the errors accordingly. No harm was caused to any patient. Conclusion: Reporting of untoward incidents and their regular analysis by APS is recommended to ensure high-quality patient care and to provide guidance in making teaching strategies and guidelines to improve patient safety.
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ahmed2015journalincident Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Aliya Ahmed;Muhammad Yasir
Journal molecular ecology resources
Year 2015
DOI
10.4103/0970-9185.169074
URL
http://www.joacp.org/article.asp?issn=0970-9185;year=2015;volume=31;issue=4;spage=501;epage=504;aulast=Ahmed
Keywords
Patient safety pain management postoperative pain

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