Research Activities, November-December 2013
Survey finds significant barriers to use of health information technology to report adverse events in nursing homes
Health Information Technology
Each year, at least 8 million adverse events occur in nursing home settings. The most commonly used method of reporting, and subsequently analyzing, an adverse event in a nursing home is through incident reporting. One strategy to reduce adverse events is through the use of health information technology (IT) to enhance incident reporting processes.
A recently published survey found several barriers to the use of health IT for this purpose. The survey asked 399 nursing home administrators about the factors that either promote or prevent health IT for reporting adverse incidents.
Two of the top three most important barriers identified by nursing home administrators were related to fears of reporting. The three barriers were:
- Lack of recognition that an adverse event had occurred.
- Fear of liability, lawsuits, or sanctions.
- Fear of disciplinary action, which was tied to fear of being blamed.
The researchers believe that health IT structures can help improve incident reporting by minimizing staffs' fear of reporting events. For example, computerized incident reporting systems have the potential for staff to anonymously report safety concerns and adverse events.
The last ranked barrier in area of importance, "lack of a readily available adverse event reporting system," is an important finding, since nursing home administrators might not see the importance that health IT plays in incident reporting. Researchers found very few health IT-related facilitators present in nursing homes to enhance reporting. About 15 percent of nursing homes had computerized entry by the nurse on the unit and almost 18 percent used no computer technology to track, monitor, or maintain adverse event data. One third of nursing directors conducted data analysis by hand.
The researchers call for the use of a more standardized system to assess, analyze, and disseminate adverse event data to facilitate adverse event reporting.
This study was supported by AHRQ (HS16547, HS18721). See "Use of HIT for adverse event reporting in nursing homes: Barriers and facilitators," by Laura M. Wagner, Ph.D., R.N., Nicholas G. Castle, Ph.D., and Steven M. Handler, M.D., M.S., in Geriatric Nursing 34, pp. 112-115, 2013.