[Epidemiological factors associated with safety incidents due to patient behavior reported in the hospital setting.]

Torá Rocamora, Isabel; Aldecoa Alió, Júlia; Bertran Luengo, Maria Jesús; Prat Marín, Andrés

OBJECTIVE Incident reporting systems are an essential element in hospital safety programs. Our objective was to describe the magnitude, evolution and characteristics of adverse events due to patient behavior reported in a high complexity reference university hospital. METHODS Cross-sectional study. Period 2016-2019. From the hospital registry of adverse events, the notifications of the taxonomy "Patient behavior" were obtained. They were classified according to: type of behavior, category of the reporting professional, care area, sex of the patient/companion, risk and year. The χ² test for the comparison of qualitative variables was used, and using a generalized linear model with Poisson distribution, prevalence ratio (PR) and 95% confidence intervals (95%CI) were estimated. RESULTS Patient behavior reported incidents represented the 8.2%. There was an increasing trend with a slight decrease in the last year (2016 12.4%; 2017 29.5%; 2018 32.5% and 2019 25.6%). The areas of neurological and psychiatric diseases, and emergencies reported 36.9% and 19.7% of the cases, respectively. Nursing was the most reporting group (73.2%). More than 60% of notifications involved male patients. The PR doubled in escapes or attempts (2.2;95%CI=1.4-3.5), tripling in non-compliance with hospital rules (3.0;95%CI=1.9-4.7) and aggressive or intimidating behaviors (3.4:95% CI=2.2-5.3). CONCLUSIONS An increase in notifications related to patient behaviors is observed, with a slight decrease in the last year. This study objectively shows and characterizes a problem that is now especially relevant due to the influence of the COVID-19 pandemic on mental health, which quality and clinical safety programs must consider to minimize the associated risks.