Assessing the Impact of COVID-19 on Incident Reporting and Elucidating the Characteristics of Incident Reports for COVID-19 Patients at the Critical Care Center of a Tertiary-Care Teaching Hospital in Japan

Hiroshi Kawaguchi,^1,2 Hiroshi Kakeya² and Etsuko Nakagami-Yamaguchi3³

¹Department of Pharmacy, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
²Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Osaka, Osaka, Japan
³Department of Medical Quality and Safety Science, Osaka Metropolitan University Graduate School of Medicine, Osaka, Osaka, Japan

The global coronavirus disease 2019 (COVID-19) pandemic has necessitated the establishment of new medical care systems worldwide. Medical staff treating COVID-19 patients perform their care duties in highly challenging and psychologically demanding situations, raising concerns about their impact on patient safety. Therefore, this study aimed to investigate and characterize incident reports related to COVID-19 patients to clarify the impact of COVID-19 on patient safety. The study included data from 557 patients admitted to the Critical Care Center of a tertiary-care teaching hospital in Osaka, Japan, from April 2020 to March 2021. The patients were divided into two groups: COVID-19 (n = 106) and non-COVID-19 (n = 451) and compared based on various characteristics, incident reporting rates, and the content of incident reports. The findings indicated a significantly higher rate of patients with incident reports in the COVID-19 group compared to the non-COVID-19 group (49.1% vs. 24.4%, P < 0.001). In addition, quantitative text analysis revealed that the topic ratio, consisting of "respiration," "circuit," "settings," "connection," "nursing," "ventilator," "control," "tape," "Oxylog," and "artificial nose" was significantly higher in the incident reports of the COVID-19 group (P = 0.003). In conclusion, COVID-19 patients are more susceptible to adverse incidents and may face a higher risk of patient safety issues. The characteristic topics in incident reports involving COVID-19 patients primarily revolved around ventilator-related issues. In the future, the methodology used in the current study may be utilized to identify incident characteristics and implement appropriate countermeasures in the event of unknown patient safety issues.

Key words —— COVID-19; critical care center; incident reports; patient safety; quantitative text analysis

Tohoku J. Exp. Med., 2024 January, 262(1), 5-12.

Correspondence: Etsuko Nakagami-Yamaguchi, Department of Medical Quality and Safety Science, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Osaka 545-8585, Japan.

e-mail: nyamaguchi.e@omu.ac.jp