Examples of adverse event type | Number (%) |
---|---|
Organisation | Â |
• wrong form was sent with a PAP smear so it could not be evaluated | 116 (55.0) |
• referral letter was not ready when promised |  |
• 24 hour blood pressure measurement agreed upon but not performed |  |
Treatment | Â |
• Patient uses three kinds of antihistaminics | 31 (14.7) |
• AB prescribed although patient is allergic |  |
• Too low doses of PPI had been prescribed |  |
Communication | Â |
• Patient was not told that lab test should be performed on an empty stomach, so had to be repeated | 26 (12.3) |
• Patient was told to inhale salbutamol (a pulmonary β2 adrenergic receptor agonist) prior to the long function test |  |
• GP agreed to call the patient but forgot |  |
Diagnosis | Â |
• Recurrent urine infection in a male, without further diagnostics |  |
• Patient exercise induces shoulder pain, which is considered musculoskeletal; no further research is done; five days later patient is admitted to hospital with a myocardial infarction | 21 (10.0) |
• Lab result interpreted incorrectly |  |
Prevention | Â |
• No action on elevated cholesterol in a patient with multiple vascular risk factors | 14 (6.6) |
• A fasting glucose test was agreed upon, but not performed |  |
• Administration of NSAID without gastric protection in an elderly patient |  |
Triage | Â |
• A patient calls with a high fever and pyelonephritis complaints. A home-visit is planned for the next day | 3 (1.4) |