Adverse Events in Home-Care Nursing Agencies and Related Factors: A Nationwide Survey in Japan
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design and Data Collection
2.2. Measurements
2.2.1. Number of Adverse Events
2.2.2. Process of Care for Patient Safety
2.2.3. Agency Characteristics
2.3. Statistical Analysis
2.4. Ethical Considerations
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Study Participants | Survey of Institutions and Establishments for Long-Term Care in 2018 | |||
---|---|---|---|---|
n = 565 | n = 10884 | |||
Region (n,%) | ||||
Hokaido | 31 | 5.6 | 492 | 4.5 |
Tohoku | 27 | 4.9 | 619 | 5.7 |
Kanto | 146 | 26.3 | 2967 | 27.3 |
Chubu | 74 | 13.3 | 1704 | 15.7 |
Kinki | 133 | 23.9 | 2576 | 23.7 |
Shikoku chugoku | 59 | 10.6 | 1082 | 9.9 |
Kyusyu okinawa | 86 | 15.5 | 1444 | 13.3 |
Missing | 9 | 1.6 | 0 | 0.0 |
Agency ownership (n,%) | ||||
Healthcare corporation | 158 | 28.0 | 2802 | 25.7 |
Profit | 255 | 45.1 | 5476 | 50.3 |
Social welfare | 103 | 18.2 | 2141 | 19.7 |
Others | 35 | 6.2 | 223 | 2.0 |
Missing | 14 | 2.5 | 242 | 2.2 |
Number of nurses (full-time equivalent) (mean, standard deviation) | 4.9 | 3.1 | 5.3 | N.A |
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Variables | ||
---|---|---|
Operating and management | ||
Agency ownership (n,%) | ||
Healthcare corporation | 111 | 27.8 |
Profit | 177 | 44.3 |
Social welfare | 88 | 22.0 |
Others | 24 | 6.0 |
Number of nurses (full-time equivalent) (median, 25—75 percentile) | 4.0 | 3.0–5.8 |
Number of users in a month (median, 25—75 percentile) | 53.5 | 29.5–79.5 |
Patient characteristics | ||
Accepts pediatric patient (n, %) | ||
Yes | 92 | 23.0 |
No | 308 | 77.0 |
Accepts patient at terminal care stage (n, %) | ||
Yes | 105 | 26.3 |
No | 295 | 73.8 |
Percentage of users with care-need level ≥3 (median, 25—75 percentile) | 28.0 | 18.7–38.0 |
Percentage of users who needs medical treatment (median, 25—75 percentile) | 16.3 | 6.8–27.5 |
Process of care for patient safety | ||
Having a manual for patient safety (n,%) | ||
Yes | 357 | 89.3 |
No | 43 | 10.8 |
Having a committee for adverse event prevention (n,%) | ||
Yes | 106 | 26.5 |
No | 294 | 73.5 |
Training for adverse event prevention (n,%) | ||
Yes | 209 | 52.3 |
No | 191 | 47.8 |
n | % | |
---|---|---|
Total number of adverse events | 1937 | 100.0 |
By types | ||
Pressure ulcers | 1725 | 80.5 |
Urinary tract infection | 127 | 5.9 |
Falling | 36 | 1.7 |
Tube-related error | 17 | 0.8 |
Catheter related infection | 12 | 0.6 |
Aspiration | 8 | 0.4 |
Medication error | 6 | 0.3 |
Device-related error | 6 | 0.3 |
Univariate ZINB | Multivariate ZINB | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Negative Binomial Part | Inflated Part | Negative Binomial Part | Inflated Part | |||||||||||||
Coef. | 95% CI | p-Value | Coef. | 95% CI | p-Value | Coef. | 95% CI | p-Value | Coef. | 95% CI | p-Value | |||||
Agency ownership (ref. healthcare corporation) | ||||||||||||||||
Profit | 0.01 | −0.28 | 0.30 | 0.936 | 0.35 | −0.44 | 1.13 | 0.386 | −0.06 | −0.34 | 0.23 | 0.700 | 0.34 | −0.49 | 1.17 | 0.417 |
Social welfare | 0.03 | −0.29 | 0.35 | 0.859 | −2.46 | −7.66 | 2.74 | 0.354 | −0.17 | −0.50 | 0.16 | 0.319 | −1.86 | −6.05 | 2.32 | 0.383 |
Others | 0.31 | −0.19 | 0.81 | 0.222 | −0.44 | −2.18 | 1.30 | 0.621 | 0.18 | −0.29 | 0.65 | 0.444 | −0.33 | −1.98 | 1.32 | 0.695 |
Accepts pediatric patient (ref. does not accept) | 0.32 | 0.07 | 0.58 | <0.05 | −1.08 | −2.33 | 0.16 | 0.089 | 0.10 | −0.22 | 0.42 | 0.530 | −0.04 | −1.42 | 1.33 | 0.949 |
Accepts patient at terminal care stage (ref. does not accept) | 0.42 | 0.17 | 0.66 | <0.01 | −0.62 | −1.50 | 0.27 | 0.172 | 0.14 | −0.12 | 0.40 | 0.297 | −0.35 | −1.40 | 0.70 | 0.515 |
Percentage of users with care-need level ≥3 (ref. first quartile) | ||||||||||||||||
second quartile | 0.33 | −0.01 | 0.68 | 0.059 | −0.76 | −1.66 | 0.14 | 0.097 | 0.36 | 0.04 | 0.69 | <0.05 | −0.44 | −1.48 | 0.61 | 0.412 |
third quartile | 0.28 | −0.06 | 0.62 | 0.109 | −1.70 | −3.18 | −0.21 | <0.05 | 0.27 | −0.05 | 0.60 | 0.099 | −0.90 | −2.05 | 0.26 | 0.128 |
fourth quartile | 0.35 | 0.01 | 0.70 | <0.05 | −0.91 | −1.86 | 0.03 | 0.058 | 0.37 | 0.04 | 0.70 | <0.05 | −0.76 | −1.77 | 0.25 | 0.142 |
Percentage of users who needs medical treatment (ref. first quartile) | ||||||||||||||||
second quartile | −0.15 | −0.50 | 0.19 | 0.389 | −0.95 | −1.94 | 0.03 | 0.059 | −0.17 | −0.50 | 0.17 | 0.334 | −0.37 | −1.39 | 0.66 | 0.485 |
third quartile | 0.18 | −0.15 | 0.52 | 0.281 | −1.17 | −2.16 | −0.18 | <0.05 | 0.08 | −0.25 | 0.41 | 0.624 | −0.52 | −1.55 | 0.51 | 0.326 |
fourth quartile | 0.30 | −0.03 | 0.63 | 0.079 | −1.50 | −2.63 | −0.36 | <0.01 | 0.19 | −0.15 | 0.52 | 0.270 | −1.03 | −2.19 | 0.14 | 0.085 |
Having a manual for patient safety (ref. without) | 0.02 | −0.34 | 0.38 | 0.917 | 0.70 | −0.98 | 2.39 | 0.412 | −0.07 | −0.42 | 0.29 | 0.702 | 0.93 | −0.72 | 2.59 | 0.270 |
Having a committee for adverse event prevention (ref. without) | −0.35 | −0.60 | −0.09 | <0.01 | −0.15 | −0.89 | 0.59 | 0.696 | −0.23 | −0.47 | 0.01 | 0.065 | −0.33 | −1.13 | 0.47 | 0.418 |
Training for adverse event prevention (ref. no) | 0.30 | 0.07 | 0.53 | <0.05 | 0.47 | −0.29 | 1.24 | 0.226 | 0.12 | −0.11 | 0.35 | 0.307 | 0.64 | −0.21 | 1.49 | 0.143 |
Log (number of patients in a month ) | 0.35 | 0.20 | 0.49 | <0.001 | −0.70 | −1.17 | −0.24 | <0.01 | 0.26 | 0.09 | 0.44 | <0.001 | −0.79 | −1.48 | −0.10 | <0.05 |
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Morioka, N.; Kashiwagi, M. Adverse Events in Home-Care Nursing Agencies and Related Factors: A Nationwide Survey in Japan. Int. J. Environ. Res. Public Health 2021, 18, 2546. https://doi.org/10.3390/ijerph18052546
Morioka N, Kashiwagi M. Adverse Events in Home-Care Nursing Agencies and Related Factors: A Nationwide Survey in Japan. International Journal of Environmental Research and Public Health. 2021; 18(5):2546. https://doi.org/10.3390/ijerph18052546
Chicago/Turabian StyleMorioka, Noriko, and Masayo Kashiwagi. 2021. "Adverse Events in Home-Care Nursing Agencies and Related Factors: A Nationwide Survey in Japan" International Journal of Environmental Research and Public Health 18, no. 5: 2546. https://doi.org/10.3390/ijerph18052546