Sveikatos priežiūros kokybės ligoninėje pokyčiai valstybės lygio ekstremaliosios situacijos ir karantino dėl Covid-19 metu nepageidautinų įvykių aspektu: atvejo analizė

LTSveikatos priežiūros kokybė ligoninėse ir vienas jos žymenų – nepageidautini įvykiai (kiekis, spektras, pasekmės) valstybės lygio ekstremaliosios situacijos ir karantino dėl Covid-19 metu gali skirtis nuo būklės ikiepideminiu laikotarpiu. Tyrimo tikslas – įvertinti nepageidautinų įvykių ligoninėje pokyčius ir jų įtaką sveikatos priežiūros kokybei valstybės lygio ekstremaliosios situacijos ir karantino dėl Covid-19 metu. Atliekant tyrimą, analizuotos įvairių šalių autorių mokslinės publikacijos, tirti nepageidautinų įvykių ekspertuoti pranešimai valstybės lygio ekstremaliosios situacijos ir karantino dėl Covid-19 metu 2020 m. ir tuo pačiu laikotarpiu 2019 metais. Atskleisti nepageidautinų įvykių spektro, priežastinių veiksnių, rizikos laipsnių bei išvengiamumo pokyčiai ir jų priežastys. Duomenys palyginti su kitų šalių patirtimi. Nustatyta, kad įvairūs nepageidautinų įvykių aspektai valstybės lygio ekstremaliosios situacijos ir karantino dėl Covid-19 metu ir tuo pačiu laikotarpiu iki Covid-19 epidemijos yra skirtingi. [Iš leidinio]

ENAdverse events are one of the most important markers of quality in hospitals. Various global factors, including pandemics, influence changes in adverse events in hospitals. The aim of the study – to evaluate the changes in adverse events in hospital and their impact on health care quality during state-level emergency and Covid-19 quarantine. Material and methods. Research object – adverse events in Klaipeda University Hospital. Research methods – analysis of scientific literature, data analysis of adverse events reporting forms, comparative content analysis and synthesis, summaries and conclusions. Inpatients adverse events from February 26 to December 31, 2020 (during state-level emergency and Covid-19 quarantine) were studied and compared to the same period in 2019. Analysis of statistical data was done using the software SPSS version 23. Results. In 2020, 0,3% of adverse events from all hospitalized patients were reported and registered at the hospital, compared to 0,5% in 2019. During state-level emergency and Covid-19 quarantine in 2020 more adverse events have been reported and recorded in more men and patients over 50 years of age. During this period there was a decrease in surgical and obstetrics – gynecology and an increase in nursing adverse events. There was a decrease in birthrelated and related to operations adverse events, but an increase in the number of patients' falls.Assessing the degree of risk of adverse events, it was found that in 2020 there was a significant increase in minimal risk and a decrease in medium-and high-risk adverse events, as well as related deaths. Examining the causal factors of the adverse events we see, that according to doctors and experts, they decreased due to the individual characteristics of the patients in 2020. Adverse events avoidance analysis showed reducing the number of unavoidable events and an increase in the number of events that could be completely or partially avoided by doctors assessment. According to experts, in 2020 more adverse events could have been avoided. Conclusions. There were more adverse events during the statelevel emergency and Covid-19 quarantine at the Klaipeda University hospital than at the same preepidemic time, but they did not effect the health care quality changes. The structure, spectrum and causes of adverse events did not change significantly during state-level emergency and Covid-19 quarantine. The degree of risk (consequences) of adverse events during state-emergency and Covid-19 quarantine was milder, less dangerous to the patients' health. The chances of adverse events avoidance during state-emergency and Covid-19 quarantine were higer than in 2019. [From the publication]

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