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Objective: To know the nurses' perception of the factors that influence the safe administration of medications in the work context of the General University Hospital of Elda (Alicante), Spain. Method: This is a qualitative phenomenological study through interviews semi-structured in which 15 nurses chosen by deliberate sampling participated. Results: The participants expressed concern about the performance of the medication administration procedures, which made it possible to perceive safety as the greatest concern in the study unit. A main category called "knowing" was established, which encompasses all the reflections about the nurse's performance during the medication administration process. The following subcategories are developed from this main category: work overload, insufficient training, distractions, and communication and information failures. Conclusion: Knowing the nurses' perception of the factors that influence the safe administration of medications could facilitate the use of instruments to standardize and reduce variability in the safe administration of medications. As well as improving conditions in work environments and not favoring social, personal and professional stigmatization due to care error. [ABSTRACT FROM AUTHOR]

Study of the frequency of healthcare-related adverse events (AE) and of their effect on patients and impact on healthcare systems has markedly increased in recent years. Indepth individual analysis of the factors contributing to these events has allowed strategies to prevent or minimize the impact of AE to be developed. However, an epidemiologic perspective is needed to explore possible associations and generalize the recommendations that can be drawn from this type of analysis. Some aspects that should been considered while developing future strategies are discussed. These aspects include the importance of patient age and comorbidities on producing AE and the use of highly technological medicine, which is sometimes unnecessary. A culture of trust and confidentiality and a spirit of collaboration among organizations are indispensable to share and learn about the initiatives prompted by the study of AE and thereby improve patient safety in the national health service.

Objective: To determine the incidence of patients with adverse events (AE) in Spanish general surgery units, describe the immediate causes of AE, identify avoidable AE, and determine the impact of these events., Material and Method: We performed a retrospective cohort study of a randomized stratified sample of 24 hospitals. Six of the hospitals were small (fewer than 200 beds), 13 were medium-sized (between 200 and 499 beds) and five were large (500 or more beds). Patients admitted for more than 24 hours to the selected hospitals and who were discharged between the 4th and 10th of June 2005 were included. AE detected during hospitalization and those occurring as a consequence of previous admissions in the same hospital were analyzed., Results: The incidence of patients with AE associated with medical care was 10.5% (76/735; 95%CI: 8.1%-12.5%). The presence of intrinsic risk factors increased the risk of AE (14.8% vs 7.2%; P=.001). Likewise, 16.2% of patients with an extrinsic risk factor had an AE compared with 7.0% of those without these risk factors (P< .001). Comorbidity influenced the occurrence of AE (33.7% of AE vs. 2.2% without comorbidity; P< .001). The severity of the AE was related to ASA risk (P=.036). AE were related to nosocomial infection (41.7%), procedures (27.1%) and medication (24%). A total of 31.3% of the AE were mild, 39.6% were moderate, and 29.2% were severe. Preventable AE accounted for 36.5%. AE caused an additional 527 days of stay (6.3 additional days of stay per patient), of which 216 were due to preventable AE., Conclusions: Patients in general and digestive surgery units have an increased risk of AE. Risk factors for these events are age, comorbidity, and the use of external devices. A substantial number of AE are related to nosocomial infection (especially surgical wound infection) and to surgical procedures. AE have an important impact on patients and a considerable proportion of these events are preventable. AE have strong health, social and economic repercussions and until recently have constituted a silent epidemic in Spain. Consequently, study of these events should be a public health priority.