title: Indicators of healthcare results: analysis of adverse events during hospital stays.
abstract: This quantitative, retrospective study aimed to characterize adverse events (AE) in Intensive Care Units (ICU), Semi-Intensive Care Units (SCU) and Inpatient Units (IU), regarding nature, type, day of the week and nursing professionals / patient ratio at the moment of occurrence; as well as to identify nursing interventions after the event and AE rates. The study was performed at a private hospital in the city of São Paulo, Brazil. Two hundred twenty-nine AE were notified. The predominant events were related to nasogastric tubes (NGT) (57.6%), followed by patient fall (16.6%) and medication errors (14.8%). The nursing professionals /patient ratio at the moment of the event was 1:2 for the ICU, 1:3 for the SCU and 1:4 for the IU. A similar distribution was observed for the other days of the week. The nursing interventions were: repositioning the NGT (83.2%) and communication of the occurrence to the physician in case of medication errors (47.6%) and falls (55.2%). The highest AE rate was related to NGT.
authors.affiliation: Hospital Alemão Oswaldo Cruz, Brazil. camilanascimetno@yahoo.com.br
authors.forename: Camila Cristina Pires
authors.initials: CC
authors.lastname: Nascimento
authors.forename: Maria Cecília
authors.initials: MC
authors.lastname: Toffoletto
authors.forename: Leilane Andrade
authors.initials: LA
authors.lastname: Gonçalves
authors.forename: Walkíria das Graças
authors.initials: Wd
authors.lastname: Freitas
authors.forename: Katia Grillo
authors.initials: KG
authors.lastname: Padilha
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D009732:Nursing Care / Q000706:statistics & numerical data*; D009738:Nursing Service, Hospital / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome