Wrong-Patient Orders in Obstetrics.
Adult
Female
Hospital Units
/ statistics & numerical data
Humans
Maternal Health Services
/ statistics & numerical data
Medical Errors
/ statistics & numerical data
Medication Errors
/ statistics & numerical data
Obstetrics
/ statistics & numerical data
Odds Ratio
Pregnancy
Retrospective Studies
Risk Factors
Specialization
/ statistics & numerical data
Surgical Procedures, Operative
Journal
Obstetrics and gynecology
ISSN: 1873-233X
Titre abrégé: Obstet Gynecol
Pays: United States
ID NLM: 0401101
Informations de publication
Date de publication:
01 08 2021
01 08 2021
Historique:
received:
07
02
2021
accepted:
08
04
2021
pubmed:
9
7
2021
medline:
1
10
2021
entrez:
8
7
2021
Statut:
ppublish
Résumé
To compare rates of wrong-patient orders among patients on obstetric units compared with reproductive-aged women admitted to medical-surgical units. This was an observational study conducted in a large health system in New York between January 1, 2016, and December 31, 2018. The primary outcome was near-miss wrong-patient orders identified using the National Quality Forum-endorsed Wrong-Patient Retract-and-Reorder measure. All electronic orders placed for eligible patients during the study period were extracted retrospectively from the health system data warehouse, and the unit of analysis was the order session (consecutive orders placed by a single clinician for a patient within 60 minutes). Multilevel logistic regression models were used to estimate odds ratios (ORs) and 95% CIs comparing the probability of retract-and-reorder events in obstetric and medical-surgical units, overall, and in subgroups defined by clinician type and order timing. Overall, 1,329,463 order sessions were placed during the study period, including 676,643 obstetric order sessions (from 45,436 patients) and 652,820 medical-surgical order sessions (from 12,915 patients). The rate of 79.5 retract-and-reorder events per 100,000 order sessions in obstetric units was significantly higher than the rate in the general medical-surgical population of 42.3 per 100,000 order sessions (OR 1.98, 95% CI 1.64-2.39). The obstetric retract-and-reorder event rate was significantly higher for attending physicians and house staff compared with advanced practice clinicians. There were no significant differences in error rates between day and night shifts. Order errors occurred more frequently on obstetric units compared with medical-surgical units. Systems strategies shown to decrease these events in other high-risk specialties should be explored in obstetrics to render safer maternity care.
Identifiants
pubmed: 34237762
doi: 10.1097/AOG.0000000000004474
pii: 00006250-202108000-00009
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
229-235Subventions
Organisme : AHRQ HHS
ID : R01 HS024538
Pays : United States
Organisme : AHRQ HHS
ID : T32 HS026121
Pays : United States
Informations de copyright
Copyright © 2021 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Financial Disclosure Clyde B. Schechter disclosed receiving funding from AHRQ, Mt. Sinai School of Medicine, Georgetown University, and the National Institutes of Health—Office of Scientific Review. He also received funding directly from the Social Science Research Council for consulting. Dena Goffman reports receiving funds from Roche. The other authors did not report any potential conflicts of interest.
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