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J Nurs Manag. 2009 Mar;17(2):165-74. doi: 10.1111/j.1365-2834.2009.00974.x.

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

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Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, Ontario, Canada.



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.


Problems of patient safety have been well documented in hospitals. However, we have very limited data about patient safety problems among HC clients.


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.


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%).


Understanding clients' risk profiles is foundational to effective patient care management.


We need to begin to develop evidence about best practices for ameliorating safety risk.

[Indexed for MEDLINE]

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