Adverse events among children in Canadian hospitals: the Canadian Paediatric Adverse Events Study

Abstract
Background: Limited data are available on adverse events among children admitted to hospital. The Canadian Paediatric Adverse Events Study was done to describe the epidemiology of adverse events among children in hospital in Canada.
Methods: We performed a 2-stage medical record review at 8 academic pediatric centres and 14 community hospitals in Canada. We reviewed charts from patients admitted from April 2008 through March 2009, evenly distributed across 4 age groups (0 to 28 d; 29 to 365 d; > 1 to 5 yr and > 5 to 18 yr). In stage 1, nurses and health records personnel who had received training in the use of the Canadian Paediatric Trigger Tool reviewed medical records to detect triggers for possible adverse events. In stage 2, physicians reviewed the charts identified as having triggers and described the adverse events.
Results: A total of 3669 children were admitted to hospital during the study period. The weighted rate of adverse events was 9.2%. Adverse events were more frequent in academic pediatric centres than in community hospitals (adjusted odds ratio [OR] 2.98, 95% confidence interval [CI] 1.65–5.39). The incidence of preventable adverse events was not significantly different between types of hospital, but nonpreventable adverse events were more common in academic pediatric centres (adjusted OR 4.39, 95% CI 2.08–9.27). Surgical events predominated overall and occurred more frequently in academic pediatric centres than in community hospitals (37.2% v. 21.5%, relative risk [RR] 1.7, 95% CI 1.0–3.1), whereas events associated with diagnostic errors were significantly less frequent (11.1% v. 23.1%, RR 0.5, 95% CI 0.2–0.9).
Interpretation: More children have adverse events in academic pediatric centres than in community hospitals; however, adverse events in the former are less likely to be preventable. There are many opportunities to reduce harm affecting children in hospital in Canada, particularly related to surgery, intensive care and diagnostic error.
In this issue
Article tools
Jump to section
Related Articles
Cited By...
- Adverse events in the paediatric emergency department: a prospective cohort study
- Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis
- Creation of an Enhanced Recovery After Surgery (ERAS) Guideline for neonatal intestinal surgery patients: a knowledge synthesis and consensus generation approach and protocol study
- Adverse Events in Hospitalized Pediatric Patients
- Status Complexicus? The Emergence of Pediatric Complex Care
- Patient safety vulnerabilities for children with intellectual disability in hospital: a systematic review and narrative synthesis
- Effectiveness and meaningful use of paediatric surgical safety checklists and their implementation strategies: a systematic review with narrative synthesis
- The Irish National Adverse Events Study (INAES): the frequency and nature of adverse events in Irish hospitals--a retrospective record review study
- Development of a Pediatric Adverse Events Terminology
- Disclosure of Adverse Events in Pediatrics
- Effect of surgical safety checklists on pediatric surgical complications in Ontario
- Recommendations for surgical safety checklist use in Canadian childrens hospitals
- Temporal trends in patient safety in the Netherlands: reductions in preventable adverse events or the end of adverse events as a useful metric?
- Application of a trigger tool in near real time to inform quality improvement activities: a prospective study in a general medicine ward
- How safe are our paediatric emergency departments? Protocol for a national prospective cohort study
- Trying to Improve Care: The Morbidity and Mortality Conference in a Division of Rheumatology
- The morbidity and mortality conference as an adverse event surveillance tool in a paediatric intensive care unit
- Prevalence and severity of patient harm in a sample of UK-hospitalised children detected by the Paediatric Trigger Tool
- Utility of a Paediatric Trigger Tool in a Norwegian department of paediatric and adolescent medicine
- Improving care for the deteriorating child