Lecture critique – Les événements indésirables diminuent-ils avec le temps ? – Une vision longitudinale en Irlande

Résumé

Titre de l'article sujet de la Lecture critique : Connolly W¹, Rafter N², Conroy RM3, Stuart C⁴, Hickey A5, Williams DJ¹. The Irish national adverse event study-2 (INAES-2): longitudinal trends in adverse event rates in the Irish healthcare system. BMJ Qual Saf 2021. Doi : 10.1136/bmjqs-2020-011122. ^{1-Department of geriatric and stroke medicine – Royal College of surgeons in Ireland – Dublin – Ireland2-Division of population health sciences – Department of epidemiology and public health – Royal College of surgeons in Ireland – Dublin – Ireland3-Division of population health sciences – Royal College of surgeons in Ireland – Dublin – Ireland4-Health service executive – Dublin – Ireland5-Division of population health sciences – Department of psychology – Royal College of surgeons in Ireland – Dublin – Ireland}

Objectives. To quantify the prevalence and nature of adverse events in acute Irish hospitals in 2015 and to assess the impact of the National Clinical Programmes and the National Clinical Guidelines on the prevalence of adverse events by comparing these results with the previously published data from 2009. Design and Methods. A retrospective chart review of 1 605 admissions to eight Irish hospitals in 2015, using identical methods to those used in 2009. Results. The percentage of admissions associated with one or more adverse events was unchanged (p=0.48) at 14% (CI95=10.4-18.4) in 2015 compared with 12.2% (CI95=9.5-15.5) in 2009. Similarly, the prevalence of preventable adverse events was unchanged (p=0.3) at 7.4% (CI95=5.3-10.5) in 2015 compared with 9.1% (CI95=6.9-11.9) in 2009. The incidence densities of preventable adverse events were 5.6 adverse events per 100 admissions (CI95=3.4-8.0) in 2015 and 7.7 adverse events per 100 admissions (CI95=5.8-9.6) in 2009 (p=0.23). However, the percentage of preventable adverse events due to hospital-associated infections decreased to 22.2% (CI95=15.2-31.1) in 2015 from 33.1% (CI95=25.6-41.6) in 2009 (p=0.01). Conclusion. Adverse event rates remained stable between 2009 and 2015. The percentage of preventable adverse events related to hospital-associated infection decreased, which may represent a positive impact of the related national programs and guidelines.