To explore the hospital-related adverse events endured by people with dementia and assess their association with negative outcomes related to hospital care. A scoping review was undertaken in October 2023. Primary studies published in peer-reviewed journals in English, Spanish, or Portuguese were included. The databases PubMed, Web of Science, CINAHL, and Scopus were searched. Of the 1976 retrieved studies, 16 were included. Adverse events were more frequent among people with dementia compared to people without dementia. In studies with non-surgical and surgical patients, the most frequently reported were falls, delirium, and infections, while in studies exclusively conducted with surgical patients, these were postoperative delirium, infections, and other complications. The link between adverse events and negative outcomes was explored in only three studies and indicated that those who experienced adverse events had longer hospital stays, higher risk of mortality, and higher readmission rates within 90 days. Although we were unable to establish a direct link between adverse events and hospital outcomes due to the exploratory nature of this review, the findings suggest that mitigating such events could help improve outcomes among hospitalized people with dementia. Hospital safety measures appear to be insufficient to protect this group.

<!--Texto completo:--> FULL TEXT <!--GALEY ICONS--> <!-- END ICONS--> PDF Objetivo: Determinar la frecuencia, las causas y los factores asociados de suspensión de cirugías programadas en un hospital de alta complejidad en un periodo de 5 años. Materiales y métodos: Se realizó un estudio descriptivo transversal, en un hospital terciario del sur de Chile durante los años 2014 a 2018. Se describe la frecuencia de suspensión quirúrgica del establecimiento y por especialidad, especificando sus principales causas. Además, se identificaron aquellas suspensiones evitables y sus factores asociados mediante regresión logística. Resultados: La tasa de suspensión en los 5 años de estudio fue de 11,2%. Neurocirugía y Traumatología tuvieron la mayor tasa de suspensión (18,8% y 13,9%, respectivamente), mientras que Ginecología y Obstetricia la menor (4,1%). Las causas más frecuentes fueron la inasistencia del paciente (16,9%), la prolongación de la cirugía anterior (16,4%) y la paralización de actividades por motivos gremiales (7,9%). Un 80,1% de las causas fueron evitables. La especialidad quirúrgica y la edad del paciente fueron los factores asociados más relevantes. Discusión: Se evidenció una alta tasa de suspensiones quirúrgicas y la mayoría por causas evitables. Su disminución puede ser la intervención más costo efectiva para contribuir a reducir las extensas listas de espera quirúrgica posterior a la crisis sanitaria por COVID 19, ya que sólo requiere optimizar los recursos existentes. Conclusiones: La suspensión quirúrgica es un problema frecuente en el proceso quirúrgico. Nuestros resultados permiten identificar a los grupos de mayor riesgo de suspensión, asignar responsabilidades a los equipos quirúrgicos y desarrollar estrategias efectivas para su prevención.

Objetivo: Determinar la utilización de evidencia científica disponible por el profesional de enfermería para planificar los cuidados otorgados. Metodología: Búsqueda en bases de datos: Proquest, Pubmed, Science Direct, Medline. Se seleccionó nueve artículos para análisis, publicados entre los años 2011 y 2021 en idiomas inglés y español, ajustados a requerimientos PRISMA. Resultados: Se obtuvieron 356 investigaciones, de las cuales 9 cumplieron con criterios de selección. Los artículos incluidos no miden el nivel de utilización de la Enfermería Basada en Evidencia (EBE) para la planificación de los cuidados, sin embargo, se describen factores facilitadores y barreras para su implementación. Conclusión: La evidencia disponible no es suficiente para determinar la utilización de la evidencia en los cuidados otorgados por parte del profesional de enfermería. Se describen barreras de tipo personales y organizacionales para su utilización. Para lograr una adecuada implementación de la EBE es necesario contar con estrategias efectivas en los entornos clínicos y esfuerzos multidisciplinarios para su utilización. Es necesario la realización de estudios de mayor calidad, para generar datos confiables que evidencien cómo impacta el conocimiento, el nivel de formación en investigación y el apoyo institucional en la utilización de la EBE en la práctica clínica.

Background: Second victim is the name given to the healthcare personnel—most often a nursing professional—involved with the error that led to the adverse event to a patient and who, as a result, have experienced negative psychological effects. Research with second victims has increased over the years, however concerns exist with regards to the ethical risks imposed upon these individuals. Aim: To explore the extent to which research with second victims of adverse events in healthcare settings adhere to ethical requirements. Methods: A scoping review was conducted following Arksey and O’Malley’s methodological framework and using the following databases: PUBMED, Web of Science, and SCOPUS. Original research of any study design focused on second victims and published in English, Spanish, or Portuguese in 2014–2023 were included. A critical narrative approach was used to discuss the findings. Ethical considerations: The review followed ethical guidelines emphasizing accurate authorship attribution and truthful data reporting. Results: Fifteen studies using qualitative ( n = 2), quantitative ( n = 10), and mixed-method ( n = 3) designs were included. Over half were not assessed by a research ethics committee, with questionable reasons given by the authors. One-third did not refer to having used an informed consent. In two studies, participants were recruited by their workplace superiors, which could potentially right to autonomy and voluntary participation. Conclusion: Over half of the included studies with second victims did not comply with fundamental ethical aspects, with risk to inflict respect for individual autonomy, confidentiality, and of not causing any harm to participants. Implications for nursing research: Healthcare personnel involved in adverse events are most often nursing professionals; therefore, any breach of ethics in research with this population is likely to directly affect their rights as research participants. We provide recommendations to promote better research practices with second victims towards safeguarding their rights as research participants.

Introduction: People with dementia are more likely than people without dementia to be hospitalized and to experience in-hospital preventable adverse events, such as falls, skin injury, and infection, compared to other hospitalized groups. Negative attitudes towards people with dementia are common among acute healthcare workers and have been linked to a cascade of negative adverse events in this population. However, no qualitative systematic review has ever been conducted to synthesize the existing evidence in this area, which hampers the development of preventative measures. Aim: This is a protocol for a qualitative systematic review aimed at exploring and synthesizing existing qualitative evidence regarding the attitudes of nursing staff towards the prevention of adverse events among hospitalized people with dementia. Methods: Literature searches will be performed in PubMed, CINAHL, PsycINFO, Web of Science, Biblioteca Virtual de Salud, Scopus, The Cochrane Library, and Google Scholar. The references of eligible studies will be checked for eligibility. All primary qualitative or mixed-methods studies with a qualitative component published in peer-reviewed academic journals in English, Portuguese, or Spanish will be eligible. There will be no limitations to the date of publication. The selection process will be conducted independently by two researchers using the software Rayyan and then compared and discussed. Any disagreements regarding eligibility will be discussed among the entire research team and resolved via consensus. Methodological quality will be assessed using Cochrane’s guidance. A meta-aggregative approach will be employed to extract and synthesize the evidence using the software package QARI from the JBI. The confidence in the findings will be graded using ConQual. Implications: This review will help identify and better understand specific attitudinal and psychosocial aspects that influence nursing care delivery for people with dementia in hospital settings. Such data can be used to generate novel explanatory models of nursing behaviors in dementia care, as well as capacity building and training to enhance hospital care for people with dementia globally.