1
|
Practice surrounding adverse events in residential care facilities in Ireland. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Part of regulation of residential care facilities (RCFs) is the statutory responsibility of RCFs to notify the regulator about adverse events (AEs). Notifications typically include a description of practice in the aftermath of AEs and are an information source that can inform quality and safety improvements. The herein aim therefore was to analyse narratives in notifications received by the Health Information and Quality Authority (HIQA) in Ireland, to identify practice surrounding AE management and reporting.
Methods
A sample (n = 447) of notifications received by HIQA in 2018 was drawn from the Database of Statutory Notifications from Social Care in Ireland, 2013-2019. Inductive thematic analysis was conducted. Analysis was structured using the a priori agreed themes of: practice in the aftermath of an AE, system vulnerabilities and reporting practices.
Results
Two overarching themes were identified. The first, a chronological theme contained three sub-themes: pre event, including existing measures and situations, response to the event and continued response. Measures that are resident focused and follow policies and protocols in RCFs to prevent or mitigate the seriousness of AEs, were evident in the response and continued response. From this chronological order emerged the cyclical theory where short and longer term actions become part of the pre-event of future similar or repeated AEs. The second overarching theme, regulatory input, encapsulated procedural notes, requests for further information and notes on repetitive patterns.
Conclusions
RCFs respond to AEs with short and longer term actions with resident health and wellbeing as the focus. These actions in turn become part of the pre-event of future AEs. This cycle can be leveraged for quality improvement initiatives. Input from inspectors was positive and constructive but highlighted some regulatory burden. Dissemination of these results as good practice guides may improve management and reporting of AEs.
Key messages
Residential care facilities respond to adverse events with short and long term measures which feed into the management of future AEs. This cycle can be leveraged for quality improvement initiatives. Improvement opportunities in reporting practices were found. The development of good practice guides for residential care facilities and inspectors could reduce regulatory burden.
Collapse
|
2
|
Mortality in residential care services for people with disabilities in Ireland. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
All-cause mortality is higher in people with disability than in people without disability. There is a need for descriptive epidemiological studies of deaths in people with disability to inform the development of public health interventions. All deaths in residential disability services in Ireland are notified to the Chief Inspector in the Health Information and Quality Authority (HIQA). These include notification of unexpected and expected deaths. The herein aim was to describe total, unexpected and expected deaths, and identify leading causes of death in residential disability services in Ireland.
Methods
Data on deaths in residential disability services in 2019 and 2020 were extracted from the Database of Statutory Notifications from Social Care in Ireland. The number of total deaths was calculated along with the percent and number of unexpected and expected deaths. The primary cause of death notified by services was coded using ICD-11 chapter headings.
Results
During 2019 and 2020, on average 9,115 people resided in residential disability services. Of these, 395 died, of which 45% (n = 178) were notified as unexpected. The leading causes of unexpected deaths were respiratory system diseases (35%, n = 62) and circulatory system diseases (18%, n = 32). The leading causes of expected death were respiratory system diseases (41%, n = 89) and cancers (31%, n = 67).
Conclusions
Almost half of deaths in residential disability services were notified as unexpected. Respiratory disease was the leading cause of both expected and unexpected death in people with disability residing in residential services in Ireland; three-fold the general Irish population (10.7%). Public health interventions aimed at reducing respiratory disease may reduce deaths in this group.
Key messages
In 2019 and 2020, nearly half of deaths of people with a disability residing in residential services were notified as unexpected. Death from respiratory diseases was substantially higher in people with disability living in residential services in Ireland than in the general population and warrants public health intervention.
Collapse
|