Out-of-Hospital Pediatric Patient Safety Events: Results of the CSI Chart Review

<p><b>Objective</b>: Studies of adult hospital patients have identified medical errors as a significant cause of morbidity and mortality. Little is known about the frequency and nature of pediatric patient safety events in the out-of-hospital setting. We sought to quantify pediatric patient safety events in EMS and identify patient, call, and care characteristics associated with potentially severe events. <b>Methods</b>: As part of the Children's Safety Initiative -EMS, expert panels independently reviewed charts of pediatric critical ambulance transports in a metropolitan area over a three-year period. Regression models were used to identify factors associated with increased risk of potentially severe safety events. Patient safety events were categorized as: Unintended injury; Near miss; Suboptimal action; Error; or Management complication (“UNSEMs”) and their severity and potential preventability were assessed. <b>Results</b>: Overall, 265 of 378 (70.1%) unique charts contained at least one UNSEM, including 146 (32.8%) errors and 199 (44.7%) suboptimal actions. Sixty-one UNSEMs were categorized as potentially severe (23.3% of UNSEMs) and nearly half (45.3%) were rated entirely preventable. Two factors were associated with heightened risk for a severe UNSEM: (1) age 29 days to 11 months (OR 3.3, 95% CI 1.25-8.68); (2) cases requiring resuscitation (OR 3.1, 95% CI 1.16-8.28). Severe UNSEMs were disproportionately higher among cardiopulmonary arrests (8.5% of cases, 34.4% of severe UNSEMs). <b>Conclusions</b>: During high-risk out-of-hospital care of pediatric patients, safety events are common, potentially severe, and largely preventable. Infants and those requiring resuscitation are important areas of focus to reduce out-of-hospital pediatric patient safety events.</p

sj-docx-1-heb-10.1177_10901981221123228 – Supplemental material for A Qualitative Review of Barriers and Facilitators Identified While Implementing the Native Students Together Against Negative Decisions Curriculum in a Multisite Dissemination and Implementation Study

Supplemental material, sj-docx-1-heb-10.1177_10901981221123228 for A Qualitative Review of Barriers and Facilitators Identified While Implementing the Native Students Together Against Negative Decisions Curriculum in a Multisite Dissemination and Implementation Study by Caitlin Donald, Kavita Rajani, Michelle Singer, Megan Skye, Stephanie Craig Rushing, Allyson Kelley, Brittany Morgan, Tosha Zaback, Thomas Becker and William Lambert in Health Education & Behavior</p