Types and prevalence of adverse events among obstetric clients hospitalized in a secondary healthcare facility in Ghana
Date
2019-12
Authors
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Journal ISSN
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Publisher
Journal of Patient Safety and Risk Management
Abstract
Objective: The main objective of this study was to determine the types and prevalence of adverse events among
obstetric clients hospitalized in a secondary health facility in Ghana.
Design: A retrospective study that reviewed medical records of obstetric clients on admission at the Obstetrics Unit of
a secondary healthcare facility in Ghana.
Setting: Clinical environment. The study site is the third largest health facility in Ghana that provides maternity services
and serves as the major referral facility for the Greater Accra Region, the capital of Ghana. About 41% (4676) of its total
antenatal cases (11,406) in 2015 were referrals from other facilities in Ghana. The medical records were reviewed
retrospectively from 1 January to 31 December 2015. A four-stage review process was used: the first and second stages
(by nurse/midwife reviewers) involved the identification and exclusion of records that had a length of stay of less than 24 hours
and inadequate documentation; and were unlikely to include an adverse event. The third stage by obstetrician-gynecologist reviewers included a full review of all the positive trigger folders to determine the types, causes, and degree of
preventability of the adverse events. The fourth stage involved an independent obstetrician-gynecologist review of all
records that had discrepancies. Details of the review process are presented in the figure.
Participants: Obstetric clients (i.e. pregnant women at any stage of gestation or less than 5 days after delivery who
were attended to at the hospital). About a third (1402, 49.3%) met the inclusion criteria and were reviewed.
Main outcome measures: The main outcome measure for this study was the prevalence of adverse events among
hospitalized obstetric clients.
Results: The prevalence of adverse events was 12% (168) out of 1402 records reviewed. The mean maternal age of the
clients was 30.0 5.8 years. Among these, the greatest proportion of adverse events was related to surgical interventions (66.3%), and the smallest were related to patient care (0.7%).
Conclusions: This study has provided the first documented prevalence (12.0%) and types of adverse events among
hospitalized obstetric clients in a secondary health facility in Ghana. It provides a preliminary baseline for the burden of
adverse events among the obstetric population in Ghana.
Description
Research Article
Keywords
Adverse events, obstetric clients, healthcare quality, patient safety, hospitalized