The nature of safety problems among Canadian homecare clients: evidence from the RAI-HC reporting system

AIM(S): The purpose of this study was to identify the nature of patient safety problems among Canadian homecare (HC) clients, using data collected through the RAI-HC((c)) assessment instrument. BACKGROUND: Problems of patient safety have been well documented in hospitals. However, we have very limited data about patient safety problems among HC clients. METHOD(S): The study methodology involved a secondary analysis of data collected through the Canadian home care reporting system. The study sample consisted of all HC clients who qualified to receive a RAI-HC assessment from Ontario, Nova Scotia and Winnipeg Regional Health Authority for the 2003-2007 reporting period. There were a total of 238 958 cases available for analysis; 205 953 from Ontario, 26 751 from Nova Scotia and 6254 from Winnipeg Regional Health Authority. RESULTS: New fall (11%), unintended weight loss (9%), new emergency room (ER) visits (7%) and new hospital visits (8%) were the most prevalent potential adverse events identified in our study. A small proportion of the HC clients experienced a new urinary tract infection (2%). CONCLUSION(S): Understanding clients' risk profiles is foundational to effective patient care management. IMPLICATIONS FOR NURSING MANAGEMENT: We need to begin to develop evidence about best practices for ameliorating safety risk.