Name | Nursing-Sensitive Adverse Events for Medical Patients |
Short/Other Names |
Not applicable |
Description | This indicator measures the rate of nursing-sensitive adverse events for all medical patients. The following adverse events are captured in this indicator: • Urinary tract infections (UTIs) For further details, please see the General Methodology Notes. |
Interpretation | Lower rates are desirable. High or low rates for this indicator must be interpreted with caution as they may be a consequence of inconsistent coding practices by hospitals when reporting post-admission adverse events to the DAD. |
HSP Framework Dimension |
Health System Outputs: Safe |
Areas of Need |
Getting Better |
Geographic Coverage |
All provinces/territories except Quebec |
Reporting Level/Disaggregation |
National, Province/Territory, Region, Facility, Peer Group |
Indicator Results |
Name | Nursing-Sensitive Adverse Events for Medical Patients |
Short/Other Names |
Not applicable |
Description | This indicator measures the rate of nursing-sensitive adverse events for all medical patients. The following adverse events are captured in this indicator: • Urinary tract infections (UTIs) For further details, please see the General Methodology Notes. |
Calculation: Description | The indicator is expressed as a rate of nursing-sensitive adverse events per 1,000 medical discharges. Risk-adjusted rate = Observed cases ÷ Expected cases × Canadian average Unit of analysis: Single admission |
Calculation: Geographic Assignment |
Place of service |
Calculation: Type of Measurement |
Rate - per 1,000 |
Calculation: Adjustment Applied |
The following covariates are used in risk adjustment: |
Calculation: Method of Adjustment |
Logistic regression |
Denominator |
Description: |
Numerator |
Description: |
Rationale |
A study of adverse events estimated that approximately 70,000 preventable adverse events occur annually in Canadian hospitals. Based on the definition used by the World Health Organization and other studies, adverse events refer to incidents caused by medical management instead of complications of disease. Some studies have found that adverse events increase the costs of patient care and have suggested that nurse staffing, in particular, is associated with adverse events such as pneumonia, urinary tract infections, pressure ulcers and in-hospital falls. While nurses are not solely responsible for adverse events that occur in hospital, many believe that there is a strong relationship between nurse staffing and patient outcomes. This indicator can help hospitals identify potential issues in nursing care. Further investigation and analysis based on the indicator results may possibly lead to quality improvement in nursing care. |
Interpretation |
Lower rates are desirable. High or low rates for this indicator must be interpreted with caution as they may be a consequence of inconsistent coding practices by hospitals when reporting post-admission adverse events to the DAD. |
HSP Framework Dimension |
Health System Outputs: Safe |
Areas of Need |
Getting Better |
Targets/Benchmarks |
Not applicable |
References |
Baker GR, et al. The Canadian Adverse Events Study: The incidence of adverse events among hospital patients in Canada. CMAJ. 2004. World Health Organization. WHO Draft Guidelines for Adverse Event Reporting and Learning Systems. 2005. Kellogg VA, Havens DS. Adverse events in acute care: An integrative literature review. Research in Nursing & Health. 2003. Cho SH, et al. The effects of nurse staffing on adverse events, morbidity, mortality, and medical costs. Nursing Research. 2003. Pappas SH. The cost of nurse-sensitive adverse events. Journal of Nursing Administration. 2008. Needleman J, et al. Nurse staffing in hospitals: Is there a business case for quality? Health Affairs. 2006. Unruh L. Licensed nurse staffing and adverse events in hospitals. Medical Care. 2003. Blegen MA, Vaughn TE, Goode CJ. Nurse experience and education: Effect on quality of care. Journal of Nursing Administration. 2001. White P, Hall LM. Chapter 6: Patient safety outcomes. In: Doran DM, ed. Nursing Sensitive Outcomes: State of the Science. 2003. Canadian Health Services Research Foundation. Staffing for Safety: A Synthesis of the Evidence on Nurse Staffing and Patient Safety. 2006. |
Data Sources |
DAD |
Available Data Years |
Type of Year: |
Geographic Coverage |
All provinces/territories except Quebec |
Reporting Level/Disaggregation |
National, Province/Territory, Region, Facility, Peer Group |
Update Frequency |
Every year |
Indicator Results |
Web Tool: |
Updates |
Starting in 2012–2013, the following inclusion/exclusion criteria updates were made: Starting in 2013–2014, the following inclusion criteria updates were made: |
Caveats and Limitations |
Not applicable |
Trending Issues |
Not applicable |
Comments |
Not applicable |