Prevention—Safety and Quality

Excerpt

The limited body of evidence on errors and adverse events in preventive services, especially from a nursing perspective, supports the need for additional research to move ahead in the area of patient safety. It is likely that some of the evidence from studies in ambulatory and primary care will provide direction for research and subsequent evidence-based practice in preventive care. However, there may be unique errors and adverse events associated with preventive services. It is clear that there is potential for errors and adverse events in preventive services, but additional evidence is needed to explicate what they are. The evidence that is available is largely from either descriptive studies or from randomized controlled trials (RCTs) examining the efficacy of preventive services, specifically in cancer screening. There is less systematic evaluation of counseling interventions for prevention. The nature of preventive services and their outcomes and where they are delivered increase the complexity of both establishing an evidence base and implications for practice. The continued evaluation of using information technology to address risks and adverse events is a promising area for study and practice.

The focus in safety and quality research in health care has been on preventable events rather than on preventive services. Screening, counseling, and chemoprophylaxis are the key elements of preventive services. The evidence base on errors and adverse events in preventive services is limited and needs to be developed to provide direction for practice.