Adverse events in hospitalized pediatric patients

David Stockwell, Christopher P. Landrigan, Sara L. Toomey, Samuel S. Loren, Jisun Jang, Jessica A. Quinn, Sepideh Ashrafzadeh, Michelle J. Wang, Melody Wu, Paul J. Sharek, David C. Classen, Rajendu Srivastava, Gareth Parry, Mark A. Schuster

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Patient safety concerns over the past 2 decades have prompted widespread efforts to reduce adverse events (AEs). It is unclear whether these efforts have resulted in reductions in hospital-wide AE rates. We used a validated safety surveillance tool, the Global Assessment of Pediatric Patient Safety, to measure temporal trends (2007–2012) in AE rates among hospitalized children. METHODS: We conducted a retrospective surveillance study of randomly selected pediatric inpatient records from 16 teaching and nonteaching hospitals. We constructed Poisson regression models with hospital random intercepts, controlling for patient age, sex, insurance, and chronic conditions, to estimate changes in AE rates over time. RESULTS: Examining 3790 records, reviewers identified 414 AEs (19.1 AEs per 1000 patient days; 95% confidence interval [CI] 17.2–20.9) and 210 preventable AEs (9.5 AEs per 1000 patient days; 95% CI 8.2–10.8). On average, teaching hospitals had higher AE rates than nonteaching hospitals (26.2 [95% CI 23.7–29.0] vs 5.1 [95% CI 3.7–7.1] AEs per 1000 patient days, P < .001). Chronically ill children had higher AE rates than patients without chronic conditions (33.9 [95% CI 24.5–47.0] vs 14.0 [95% CI 11.8–16.5] AEs per 1000 patient days, P < .001). Multivariate analyses revealed no significant changes in AE rates over time. When stratified by hospital type, neither teaching nor nonteaching hospitals experienced significant temporal AE rate variations. CONCLUSIONS: AE rates in pediatric inpatients are high and did not improve from 2007 to 2012. Pediatric AE rates were substantially higher in teaching hospitals as well as in patients with more chronic conditions.

Original languageEnglish (US)
Article numbere20173360
JournalPediatrics
Volume142
Issue number2
DOIs
StatePublished - Aug 1 2018
Externally publishedYes

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Pediatrics
Confidence Intervals
Teaching Hospitals
Patient Safety
Inpatients
Hospitalized Child
Insurance
Chronic Disease
Multivariate Analysis
Retrospective Studies
Safety

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Stockwell, D., Landrigan, C. P., Toomey, S. L., Loren, S. S., Jang, J., Quinn, J. A., ... Schuster, M. A. (2018). Adverse events in hospitalized pediatric patients. Pediatrics, 142(2), [e20173360]. https://doi.org/10.1542/peds.2017-3360

Adverse events in hospitalized pediatric patients. / Stockwell, David; Landrigan, Christopher P.; Toomey, Sara L.; Loren, Samuel S.; Jang, Jisun; Quinn, Jessica A.; Ashrafzadeh, Sepideh; Wang, Michelle J.; Wu, Melody; Sharek, Paul J.; Classen, David C.; Srivastava, Rajendu; Parry, Gareth; Schuster, Mark A.

In: Pediatrics, Vol. 142, No. 2, e20173360, 01.08.2018.

Research output: Contribution to journalArticle

Stockwell, D, Landrigan, CP, Toomey, SL, Loren, SS, Jang, J, Quinn, JA, Ashrafzadeh, S, Wang, MJ, Wu, M, Sharek, PJ, Classen, DC, Srivastava, R, Parry, G & Schuster, MA 2018, 'Adverse events in hospitalized pediatric patients', Pediatrics, vol. 142, no. 2, e20173360. https://doi.org/10.1542/peds.2017-3360
Stockwell D, Landrigan CP, Toomey SL, Loren SS, Jang J, Quinn JA et al. Adverse events in hospitalized pediatric patients. Pediatrics. 2018 Aug 1;142(2). e20173360. https://doi.org/10.1542/peds.2017-3360
Stockwell, David ; Landrigan, Christopher P. ; Toomey, Sara L. ; Loren, Samuel S. ; Jang, Jisun ; Quinn, Jessica A. ; Ashrafzadeh, Sepideh ; Wang, Michelle J. ; Wu, Melody ; Sharek, Paul J. ; Classen, David C. ; Srivastava, Rajendu ; Parry, Gareth ; Schuster, Mark A. / Adverse events in hospitalized pediatric patients. In: Pediatrics. 2018 ; Vol. 142, No. 2.
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AU - Quinn, Jessica A.

AU - Ashrafzadeh, Sepideh

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