Adverse events in health care: a literature review

AIM: This paper aims to develop understanding of the nature, costs and strategies to reduce or prevent a range of adverse events experienced by people within the health care system. BACKGROUND: Care interventions are not always based on safe practice and adverse events can and do occur that cause or place at risk patients lives and well-being. The nature of adverse events is diverse and can be attributed to a multitude of individual and system contributory factors and causes. EVALUATION: A review of the literature was undertaken in 2006 and 2007 using the following databases: Pubmed, CINAHL, Biomed Ovid, Synergy and the British Nursing Index. This paper evaluates the literature that pertains to adverse events and seeks understanding of this complex issue. KEY ISSUES: Published statistics confirm that globally, professional errors in clinical practice and care delivery occur at an unacceptably high level and result in considerable human and financial consequences. CONCLUSION: Reaching understanding of the multiple factors that contribute to unsafe clinical practice situations requires a cultural shift in organizations. IMPLICATION FOR NURSING MANAGEMENT: Reasons for adverse events are complex and require healthcare managers to evaluate the system issues which impact on the delivery and organization of care.