Cooper, Alison, Edwards, Adrian, Williams, Huw, Evans, Huw P., Avery, Anthony, Hibbert, Peter, Makeham, Meredith, Sheikh, Aziz, Donaldson, Liam J. and Carson-Stevens, Andrew
(2017)
Sources of unsafe primary care for older adults: a mixed-methods analysis of patient safety incident reports.
Age and Ageing, 46
(5).
pp. 833-839.
ISSN 1468-2834
Full text not available from this repository.
Abstract
Background: Older adults are frequent users of primary healthcare services, but are at increased risk of healthcare-related harm in this setting.
Objectives: To describe the factors associated with actual or potential harm to patients aged 65 years and older, treated in primary care, to identify action to produce safer care.
Design and Setting: A cross-sectional mixed-methods analysis of a national (England and Wales) database of patient safety incident reports from 2005 to 2013.
Subjects: 1,591 primary care patient safety incident reports regarding patients aged 65 years and older.
Methods: We developed a classification system for the analysis of patient safety incident reports to describe: the incident and preceding chain of incidents; other contributory factors; and patient harm outcome. We combined findings from exploratory descriptive and thematic analyses to identify key sources of unsafe care.
Results: The main sources of unsafe care in our weighted sample were due to: medication-related incidents e.g. prescribing, dispensing and administering (n = 486, 31%; 15% serious patient harm); communication-related incidents e.g. incomplete or non-transfer of information across care boundaries (n = 390, 25%; 12% serious patient harm); and clinical decision-making incidents which led to the most serious patient harm outcomes (n = 203, 13%; 41% serious patient harm).
Conclusion: Priority areas for further research to determine the burden and preventability of unsafe primary care for older adults, include: the timely electronic tools for prescribing, dispensing and administering medication in the community; electronic transfer of information between healthcare settings; and, better clinical decision-making support and guidance.
| Item Type: |
Article
|
| RIS ID: |
https://nottingham-repository.worktribe.com/output/879896 |
| Additional Information: |
This is a pre-copyedited, author-produced version of an article accepted for publication in Age and Ageing following peer review. The version of record [Cooper A, Edwards A, Williams H, Evans HP, Avery A, Hibbert P, Makeham M, Sheikh A, Donaldson LJ, Carson-Stevens A. Sources of unsafe primary care for older adults: a mixed-methods analysis of patient safety incident reports. Age and Ageing 2017; Epub ahead of print: 16 May 2017] is available online at: https://academic.oup.com/ageing/article-lookup/doi/10.1093/ageing/afx044 doi:10.1093/ageing/afx044 |
| Keywords: |
Patient safety; Quality improvement: Older adults; Primary care |
| Schools/Departments: |
University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Primary Care |
| Identification Number: |
https://doi.org/10.1093/ageing/afx044 |
| Depositing User: |
McCambridge, Mrs April
|
| Date Deposited: |
21 Jun 2017 11:00 |
| Last Modified: |
04 May 2020 19:03 |
| URI: |
https://eprints.nottingham.ac.uk/id/eprint/43680 |
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