A decade-long overview of adverse events in a tertiary surgical service in South Africa

Background. Adverse events are common, and impact patients and healthcare systems negatively. Large international systems investigate adverse events at length, but South African data are lacking. Objectives. To classify all adverse events that have occurred in our department over the last dec...

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Main Authors: H Wain, D L Clarke, S Wall
Format: Article
Language:English
Published: South African Medical Association 2024-10-01
Series:South African Medical Journal
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Online Access:https://samajournals.co.za/index.php/samj/article/view/2035
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author H Wain
D L Clarke
S Wall
author_facet H Wain
D L Clarke
S Wall
author_sort H Wain
collection DOAJ
description Background. Adverse events are common, and impact patients and healthcare systems negatively. Large international systems investigate adverse events at length, but South African data are lacking. Objectives. To classify all adverse events that have occurred in our department over the last decade. Methods. Ten years of data from a prospectively collated electronic medical record system were analysed for adverse events. All admitted patients were included. Duplicate entries and those that did not describe adverse events were excluded. Results. The study period was from December 2012 to January 2023. There were 52 835 distinct admissions covering 321 385 inpatient days. After categorisation, a total of 14 537 adverse events were captured, giving an adverse event rate of 22%. Adverse events were categorised into four groups. Of the total, 8 027 events were clinical care related, 3 106 were pathology related, 2 662 were system related and 442 miscellaneous. A total of 300 were excluded. Clinical care-related adverse events comprised 57.3% of the total number. Of those, adverse events related to indwelling devices (32.4%), iatrogenic injuries (12.5%) and intravenous therapy administration (12.5%) contributed most. Pathology-related adverse events contributed 21.4% of the total, of which wound sepsis (29.5%), anastomotic leak (15.1%) and nosocomial pneumonia (14.4%) were the most common. There was a general downward trend in reported adverse events from 2016 to 2022. Conclusion. Adverse events are common, and their aetiology is multifactorial. A sustained and multi-faceted approach is needed to address the challenge they pose.
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spelling doaj-art-f46baad18f4b4771b87b72198c8b076f2025-02-10T12:25:38ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352024-10-011141010.7196/SAMJ.2024.v114i10.2035A decade-long overview of adverse events in a tertiary surgical service in South AfricaH Wain0D L Clarke1https://orcid.org/0000-0002-8467-1455S Wall2https://orcid.org/0000-0002-3935-9139Department of Surgery, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South AfricaDepartment of Surgery, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South AfricaDepartment of Surgery, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Background. Adverse events are common, and impact patients and healthcare systems negatively. Large international systems investigate adverse events at length, but South African data are lacking. Objectives. To classify all adverse events that have occurred in our department over the last decade. Methods. Ten years of data from a prospectively collated electronic medical record system were analysed for adverse events. All admitted patients were included. Duplicate entries and those that did not describe adverse events were excluded. Results. The study period was from December 2012 to January 2023. There were 52 835 distinct admissions covering 321 385 inpatient days. After categorisation, a total of 14 537 adverse events were captured, giving an adverse event rate of 22%. Adverse events were categorised into four groups. Of the total, 8 027 events were clinical care related, 3 106 were pathology related, 2 662 were system related and 442 miscellaneous. A total of 300 were excluded. Clinical care-related adverse events comprised 57.3% of the total number. Of those, adverse events related to indwelling devices (32.4%), iatrogenic injuries (12.5%) and intravenous therapy administration (12.5%) contributed most. Pathology-related adverse events contributed 21.4% of the total, of which wound sepsis (29.5%), anastomotic leak (15.1%) and nosocomial pneumonia (14.4%) were the most common. There was a general downward trend in reported adverse events from 2016 to 2022. Conclusion. Adverse events are common, and their aetiology is multifactorial. A sustained and multi-faceted approach is needed to address the challenge they pose. https://samajournals.co.za/index.php/samj/article/view/2035adverse eventcomplicationpatient safety
spellingShingle H Wain
D L Clarke
S Wall
A decade-long overview of adverse events in a tertiary surgical service in South Africa
South African Medical Journal
adverse event
complication
patient safety
title A decade-long overview of adverse events in a tertiary surgical service in South Africa
title_full A decade-long overview of adverse events in a tertiary surgical service in South Africa
title_fullStr A decade-long overview of adverse events in a tertiary surgical service in South Africa
title_full_unstemmed A decade-long overview of adverse events in a tertiary surgical service in South Africa
title_short A decade-long overview of adverse events in a tertiary surgical service in South Africa
title_sort decade long overview of adverse events in a tertiary surgical service in south africa
topic adverse event
complication
patient safety
url https://samajournals.co.za/index.php/samj/article/view/2035
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