What is Adverse Events?
Adverse events, or AEs, are negative results that often happen in the medical field, affecting at least one in ten patients. An AE is a harmful outcome that arises when a patient receives medical care, which might be a procedure, surgery, or medication. Any patient receiving treatment may face negative consequences due to that treatment. Examples of AEs that might happen due to medical care range from medication side effects to physical injuries, psychological harm, and even death. AEs can either be preventable or something that couldn’t have been avoided. They are frequently linked to mistakes made in prescribing or giving medications. Such mishaps can happen at any point when a patient is receiving care and can range from minor to severe in terms of their impact.
What Causes Adverse Events?
Adverse events are harms that happen to patients due to their medical treatment. These can happen in many ways and for many reasons.
Some adverse events happen because of treatment like surgery or medication. It could be because of mistakes made by the person giving the treatment, or because of something in the medication. Sometimes, equipment or medical devices failing can also cause an adverse event.
An adverse event might happen unexpectedly, or as a side effect of a treatment. Even if it causes harm, the benefit of the treatment might still be greater in the long run. Many medications can potentially cause an adverse event, especially when a patient is taking multiple medications at once.
Bad communication and incorrect orders or documentation can also cause medical mistakes. If a patient isn’t correctly diagnosed, or if a diagnosis is missed completely, this could lead to an adverse event. Surgical mistakes are another potential cause of adverse events, with patients dying or receiving improper care during treatment. In addition, being treated in a certain place (like the hospital) can sometimes contribute to adverse events.
Hospital-acquired infections are a big cause of death every year, so hospitals work hard to control infection. Lastly, if a patient is discharged too early from the hospital, this can also lead to adverse events like returning to the hospital or getting injured.
Risk Factors and Frequency for Adverse Events
In the United States, over 250,000 patients receiving medical care each year experience a negative side effect, known as an adverse event. What’s more concerning, is that over 100,000 patients unfortunately die due to these adverse events. Certain populations such as vulnerable individuals, children, the elderly, and black patients are generally more at risk for adverse events. Similarly, individuals with less income or education are also more likely to experience adverse events and certain chronic illnesses.
Globally, about ten percent of patients have experienced at least one adverse event. Countries with lower income have reported higher rates of these events.
According to a systemic analysis review, each year about 10% incidence of adverse events is observed, among which 50% were considered preventable. The mortality rate associated with these adverse events is around 8%. Some of the most reported adverse events include:
- Issues related to surgical specialties
- Medication and fluid-related problems
- Healthcare-associated infections
Signs and Symptoms of Adverse Events
An adverse event is any negative outcome or harmful effect encountered during medical treatment. This can range from mild and temporary harm to severe consequences like death. At the start of any treatment, healthcare providers need to conduct a detailed history check and physical examination of the patient. This process helps identify any conditions that might make the treatment risky or ineffective.
As an example, an older patient with kidney problems should not receive treatments that are eliminated through the kidneys. The treatment plan should be customized based on the findings from the patient’s history and physical examination in order to reduce the chances of adverse events.
Testing for Adverse Events
When a serious negative event occurs during a patient’s treatment, it should be thoroughly assessed, including examining any symptoms the patient is reporting and looking into potential causes. Doctors should also educate patients about any potential side effects of their treatments and continuously monitor them for these side-effects. Severe outcomes like a patient getting injured or even losing their life during treatment should be reviewed as a priority (“sentinel”) event. The entire process around these adverse events is critically evaluated, and alternative treatments are considered if needed.
This evaluation process also involves scrutinizing any systemic issues and fixing them to avoid similar events in the future. Sometimes, an external agency may conduct a thorough review of the event.
As healthcare technology develops, systems are being created to record and even prevent these serious adverse events. The Agency for Healthcare Research and Quality (AHRQ) has developed a list of safety indicators for patients that need to be communicated to all relevant parties. Hospitals can then use this data to rectify any major system flaws, adjust treatments prone to complications, or outright remove such treatments.
In the United States, most healthcare institutions use digital systems to collect voluntary reports of any adverse events. Despite this, the number of reports is not consistent across all institutions. A culture of safety adds more reporting options and means for us to analyze medical errors. Consistently checking on the quality of care in our healthcare system includes developing these adverse event reporting protocols and making changes based on the collected data.
We can study the frequency of adverse events in hospitals using the Global Trigger Tool and the Harvard method. Several strategies exist to improve patient safety and enhance quality assurance tools, including the Plan-Do-Study-Act (PDSA) cycle and Root Cause Analysis (RCA).
Treatment Options for Adverse Events
When a patient experiences an unpleasant reaction, like feeling sick, the healthcare provider should respond quickly and appropriately. For example, if a patient feels nauseous, they can be given medication to stop this. Any unpleasant reactions that happen within a medical system need to be recorded.
Keeping track of these reactions in a database can help spot patterns and identify things that need to be changed in healthcare services, in order to reduce or even prevent these reactions from happening. It’s important to note that many believe these reactions aren’t always reported as they should be.
To make sure patients aren’t harmed, it’s crucial that healthcare providers report all reactions they come across. The analysis of these reports can then guide how management should respond and make any necessary changes to the system.
What else can Adverse Events be?
An adverse event relates to any undesirable effects that might happen due to medical treatment. The unwanted event would occur during or shortly after the treatment; the effects can range. For instance, taking medication might make you feel nauseous, but in more extreme cases, it can also lead to fatality. The term ‘adverse event’ covers all negative effects, no matter big or small. However, ‘sentinel event’ is the phrase used when the outcome involves severe harm or even death. It’s mandatory for healthcare professionals to notify of any adverse events that cause serious harm or result in a patient’s death, and these are referred to as sentinel events.
What to expect with Adverse Events
If a patient has a negative reaction or adverse event due to medical care, this could result in them being harmed or potentially even dying. The severity of the damage from this adverse event greatly influences the patient’s recovery chances or prognosis.
If the adverse event is just a temporary side effect that can be quickly managed, the patient is most likely to fully recover. However, if the injury is more serious, the patient’s prognosis might not be as positive.
It’s crucial to accurately communicate the prognosis following the adverse event to the patient. This ensures that they fully understand their situation and can make informed decisions about their health.
Possible Complications When Diagnosed with Adverse Events
Adverse events in healthcare can sometimes lead to various types of harm to the patient. Fortunately, many of these events can be treated. However, in some cases, they can cause lasting injuries or even lead to the patient’s death. It is crucial for healthcare providers to clearly communicate the possible risks of any medical treatment to the patient. This way, patients can make informed decisions about their care. This collaboration between patient and provider is known as “shared decision-making”.Remember, patients always have the right to refuse treatment. However, other factors, such as cost and convenience, can hinder effective decision-making in healthcare.
It’s important to note that the reported death rate after adverse events in hospitals is about 8%. Also, the secondary costs associated with managing these events is estimated to be about 17 billion dollars every year.
Preventing Adverse Events
Patients can help prevent unwanted health events by becoming informed and involved in their own healthcare. When doctors or healthcare providers fully disclose information to patients, involve them in making decisions, and customize treatments to meet their needs, unwelcome health events can be minimized. It’s important to fully review any expected health events with patients. Additionally, when healthcare providers report unwanted health events, this supplies important data to understand the occurrence and impact of these events. Therefore, the medical system needs to create a safe care environment by providing the necessary resources and support to report these incidents.
