Enhancing the detection of injuries and near-misses among patient care staff in a large pediatric hospital

Abstract

OBJECTIVES: Compared to other industries, healthcare has one of the highest rates of non-fatal occupational injury/illness. Evidence indicates these rates are underestimated, highlighting the need for improved injury surveillance. This study aims to demonstrate the feasibility of integrating active data collection in a passive injury surveillance system to improve detection of injuries in a healthcare establishment. METHODS: Using digital voice recorders (DVR), pediatric healthcare providers prospectively recorded events throughout their shift for two weeks. This sample-based active injury surveillance was then integrated into an institutional surveillance system (ISS) centered on passive data collection initiated by employee reports. RESULTS: Injuries reported using DVR during two-week intervals from February 2014 to July 2015 were 40.7 times more frequent than what would be expected on the basis of the usual ISS reports. Psychological injuries (eg, stress, conflict) and near-misses were captured at a rate of 16.1 per 1000 days [95% confidence interval (CI) 14.1–18.3] and 35.6 per 1000 days (95% CI 32.7–38.8), respectively. Finally, 68% (95% CI 65–72%) of participants preferred using DVR either as an alternative or complement to the existing ISS. CONCLUSIONS: This study showed that it is feasible to improve injury surveillance in a healthcare establishment by integrating active data collection based on voice recording within a passive injury surveillance system. Enhanced surveillance provides richer information that can guide the development of effective injury prevention strategies.

Keywords

• surveillance
• hospital
• injury
• near-miss
• pediatric hospital
• patient care staff
• injury detection
• active surveillance
• pediatrics
• occupational injury