title: Concurrent incidence of adverse events in hospitals and nursing homes.
abstract: OBJECTIVE
  To describe the concurrent incidence of pressure ulcers, urinary tract infections, and falls in hospitals and nursing homes, and the preventive care given. Additionally, the correlation between the occurrence of these adverse events and preventive care was explored.
  
  
  METHODS
  A prospective, 3-month, cohort study at 10 hospitals and 10 nursing homes in the Netherlands.
  
  
  METHODS
  687 hospital patients and 241 nursing home patients.
  
  
  METHODS
  The incidence of three adverse events and preventive care given to patients at risk. During weekly visits, the patients and their files were assessed. Additionally, observations were performed.
  
  
  RESULTS
  Seventy-seven hospital patients (11%) and 111 nursing home patients (46%) developed one or more adverse events. The incidence rate for both types of patients, and for the three adverse events combined, was 9% adverse events per patient week. In hospitals, 34% of the patients received adequate pressure ulcer preventive care, while 47% of the patients received adequate urinary tract infection preventive care, and none of the patients received adequate falls preventive care. In nursing homes, 18% of the patients received adequate pressure ulcer preventive care, 42% of the patients received adequate urinary tract infection preventive care, and less than 1% of the patients received adequate falls prevention care. Negative or no correlations were found between the incidence rates for the three adverse events. In nursing homes the incidence of pressure ulcers and preventive care were positively correlated.
  
  
  CONCLUSIONS
  There is a high incidence of adverse events in hospitals and nursing homes. Many patients at risk do not receive adequate preventive care.
authors.affiliation: Senior researcher, Scientific Institute for Quality of Healthcare, Radboud university medical center, Nijmegen, the Netherlands.
authors.forename: Betsie G I
authors.initials: BG
authors.lastname: Van Gaal
authors.forename: Lisette
authors.initials: L
authors.lastname: Schoonhoven
authors.forename: Joke A J
authors.initials: JA
authors.lastname: Mintjes-de Groot
authors.forename: Tom
authors.initials: T
authors.lastname: Defloor
authors.forename: Herbert
authors.initials: H
authors.lastname: Habets
authors.forename: Andreas
authors.initials: A
authors.lastname: Voss
authors.forename: Theo
authors.initials: T
authors.lastname: van Achterberg
authors.forename: Raymond T C M
authors.initials: RT
authors.lastname: Koopmans
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009735:Nursing Homes / Q000706:statistics & numerical data*; D003668:Pressure Ulcer / Q000453:epidemiology*; D011446:Prospective Studies; D014552:Urinary Tract Infections / Q000453:epidemiology*
keywords: Adverse events; hospitals; incidence; long term care; prospective studies; safety management