Patient Safety Events and Additional Hospital Stay and Direct Cost among Pediatric Patients in a Philippine Tertiary Government Hospital

Abstract

Background. Patient safety events (PSEs) in hospitalized children can lead to increased hospital stays, costs, and mortality. Knowledge of the types and prevalence of PSEs can inform targeted interventions to improve pediatric patient safety.

Objectives. This study aims to (1) determine the prevalence and types of PSEs among hospitalized pediatric patients in a tertiary government training medical center, (2) determine additional hospital days associated with each PSE type, (3) determine additional direct costs incurred due to each PSE type, (4) compare the additional hospital stay and direct costs, and (5) describe corrective and preventative actions for different PSE types.

Methods. This is a review of reports of PSEs from five inpatient service areas of the pediatric department of the hospital from April 1, 2022, to June 30, 2024. Data included additional hospital stay and direct costs sourced from the hospital's electronic health records. The number of admissions was obtained from the Department’s census. Reported findings include the prevalence of PSEs, mean, median, standard deviation, and interquartile range for additional hospital stay and direct costs. Common corrective actions identified were reinforced staff training, process improvements (double-checking medications, IV site monitoring protocols), and enhanced communication.

Results. A total of 55 PSEs were identified. Medication errors were the most frequent (61.8%). Corrective and preventative actions included reinforced staff training and double-check procedures. Extravasation injuries had the highest mean additional hospital stay (6.79 days) and the highest mean direct cost (₱1,069.49). Corrective actions and preventive actions focused on improved vascular access management.

Conclusion. Medication errors, extravasation injuries, and falls are common PSEs requiring targeted interventions within the Department of Pediatrics. Targeted initiatives emphasizing staff training, enhanced protocols, and improved communication are critical to reducing these events and improving pediatric patient safety.