1Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
2Public Health Medical Service, Seoul National University Boramae Medical Center, Seoul, Korea
3Department of Nursing, Dankook University, Cheonan, Korea
Copyright © 2015 The Korean Society for Preventive Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflict of Interest
The authors have no conflicts of interest with the material presented in this paper.
Item No. | SC | SC type |
Primary investigation (n=95) |
Secondary investigation (n=54) |
||||
---|---|---|---|---|---|---|---|---|
Agreement (%) | Kappa | 95% CI | Agreement (%) | Kappa | 95% CI | |||
1 | The index admission was an unplanned admission related to previous healthcare management | H | 99 | - | 100 | - | ||
2 | Length of index was over 30 days | H | 99 | 0.79 | 0.40, 1.00 | 100 | - | |
3 | Unplanned readmission after discharge from index admission1 | H | 100 | - | 100 | - | ||
4 | Revisiting emergency room within 72 hours after discharge from index admission | G | 96.8 | 0.71 | 0.40, 1.00 | 98.2 | 0.85 | 0.55, 1.00 |
5 | Unplanned transfer to another acute care hospital | H | 97.9 | 0.74 | 0.40, 1.00 | 98.2 | 0.66 | 0.03, 1.00 |
6 | Temperature higher than 38.3˚C at the point of discharge | H | 99 | - | 100 | - | ||
7 | Unplanned transfer from general care to intensive care1 | H, G | 100 | - | 100 | - | ||
8 | Speciality consult | G | 93.7 | 0.73 | 0.53, 0.94 | 88.9 | 0.35 | -0.04, 0.74 |
9 | Cardiac or respiratory arrest, rapid response team activation1 | H | 100 | - | 100 | - | ||
10 | Unexpected death1 | H, G | 100 | - | 100 | - | ||
11 | Healthcare-associated infection | H, G | 97.9 | 0.49 | -0.11, 1.00 | 98.2 | - | |
12 | Hospital incurred patient injury1 | H, G | 100 | - | 98.2 | - | ||
13 | Over-sedation/hypotension | G | 100 | 1.00 | 100 | - | ||
14 | Restraint use1 | G | 100 | - | 100 | - | ||
15 | Acute dialysis1 | G | 100 | - | 100 | - | ||
16 | In-unit procedure | G | 96.8 | 0.87 | 0.73, 1.00 | 92.6 | 0.68 | 0.39, 0.97 |
17 | Treatment for organ damage after an invasive procedure1 | H | 100 | - | 100 | - | ||
18 | Acute myocardial infarction, cerebrovascular accident, or pulmonary embolus during or after an invasive procedure1 | H, G | 100 | - | 100 | - | ||
19 | Transfusion or use of blood products | G | 99 | 0.79 | 0.40, 1.00 | 98.2 | 0.66 | 0.03, 1.00 |
20 | Avil (pheniramine) or Benadryl (diphenhydramine) use by intramuscular or intravenous rute | G | 95.8 | 0.78 | 0.57, 0.99 | 98.2 | 0.9 | 0.70, 1.00 |
21 | Abrupt medication stop | G | 94.7 | 0.24 | -0.15, 0.62 | 94.4 | 0.55 | 0.10, 0.99 |
22 | Antidotes use | G | 94.7 | 0.26 | -0.19, 0.71 | 98.2 | 0.66 | 0.03, 1.00 |
23 | Adverse drug reaction | H | 98.9 | 0.66 | 0.04, 0.10 | 98.2 | - | |
24 | Decrease in hemoglobin or hematocrit of 25% or greater | G | 97.9 | 0.66 | 0.22, 0.10 | 94.4 | -0.02 | -0.06, 0.01 |
25 | Hypoglycemic symptom | G | 99 | - | 98.2 | - | ||
26 | Bleeding tendency | G | 98.9 | 0.66 | 0.04, 1.00 | 98.2 | - | |
27 | Rising BUN or serum creatine greater than 2 times baseline | G | 99 | - | 100 | - | ||
28 | Clostridium difficile positive stool1 | G | 100 | - | 100 | - | ||
29 | Post-op troponin level greater than upper normal limit1 | G | 100 | - | 100 | - | ||
30 | Mechanical ventilation greater than 24 hours post-op1 | G | 100 | - | 100 | - | ||
31 | Unplanned return to the operating theatre1 | H | 100 | - | 100 | - | ||
32 | Unplanned removal, injury or repair of organ during surgery | H | 99 | - | 98.2 | - | ||
33 | Intra-op epinephrine, norepinephrine, naloxone, or romazicon1 | G | 100 | - | 100 | - | ||
34 | Unplanned change in procedure or surgery1 | H | 100 | - | 100 | - | ||
35 | Intubation, reintubation, BiPap in post anesthesia care unit1 | G | 100 | - | 100 | - | ||
36 | X-ray in post anesthesia care unit1 | G | 100 | - | 100 | - | ||
37 | Terbutaline use in obstetrics | G | 99 | - | 100 | - | ||
38 | Oxytocic agents in obstetrics | G | 100 | 1.00 | 100 | 1.00 | ||
39 | Neonatal complications such as 5-minute Apgar score<6, or complication of abortion, amniocentesis or labor and delivery1 | H, G | 100 | - | 100 | - | ||
40 | Documentation or correspondence indicating litigation, dissatisfaction1 | H | 100 | - | 100 | - | ||
41 | Any other undesirable outcomes not covered above | H | 91.6 | 0.16 | -0.17, 0.50 | 90.7 | 0.26 | -0.15, 0.68 |
Second-stage review necessity | 84.2 | 0.68 | 0.54, 0.83 | 77.8 | 0.55 | 0.33, 0.77 |
Item No. | SC | SC type |
Nurse reviewer N1 (n=54) |
Nurse reviewer N2 (n=54) |
||||
---|---|---|---|---|---|---|---|---|
Agreement (%) | Kappa | 95% CI | Agreement (%) | Kappa | 95% CI | |||
1 | The index admission was an unplanned admission related to previous healthcare management | H | 98.2 | - | 100.0 | - | ||
2 | Length of index was over 30 days | H | 100.0 | - | 100.0 | - | ||
3 | Unplanned readmission after discharge from index admission1 | H | 100.0 | - | 100.0 | - | ||
4 | Revisiting emergency room within 72 hours after discharge from index admission | G | 98.2 | 0.85 | 0.55, 1.00 | 96.3 | 0.65 | 0.19, 1.00 |
5 | Unplanned transfer to another acute care hospital | H | 100.0 | 1.00 | 100.0 | 1.00 | ||
6 | Temperature higher than 38.3˚C at the point of discharge | H | 100.0 | - | 100.0 | - | ||
7 | Unplanned transfer from general care to intensive care1 | H, G | 100.0 | - | 100.0 | - | ||
8 | Speciality consult | G | 88.9 | 0.19 | -0.22, 0.61 | 92.6 | 0.67 | 0.37, 0.97 |
9 | Cardiac or respiratory arrest, rapid response team activation1 | H | 100.0 | - | 100.0 | - | ||
10 | Unexpected death1 | H, G | 100.0 | - | 100.0 | - | ||
11 | Healthcare-associated infection | H, G | 98.2 | - | 100.0 | - | ||
12 | Hospital incurred patient injury1 | H, G | 98.2 | - | 100.0 | - | ||
13 | Over-sedation/hypotension | G | 100.0 | - | 100.0 | - | ||
14 | Restraint use1 | G | 100.0 | - | 100.0 | - | ||
15 | Acute dialysis1 | G | 100.0 | - | 100.0 | - | ||
16 | In-unit procedure | G | 100.0 | 1.00 | 96.3 | 0.85 | 0.66, 1.00 | |
17 | Treatment for organ damage after an invasive procedure1 | H | 100.0 | - | 100.0 | - | ||
18 | Acute myocardial infarction, cerebrovascular accident, or pulmonary embolus during or after an invasive procedure1 | H, G | 100.0 | - | 100.0 | - | ||
19 | Transfusion or use of blood products | G | 100.0 | 1.00 | 98.2 | 0.66 | 0.63, 1.00 | |
20 | Avil (pheniramine) or Benadryl (diphenhydramine) use by intramuscular or intravenous route | G | 92.6 | 0.47 | 0.05, 0.89 | 98.2 | 0.90 | 0.70, 1.00 |
21 | Abrupt medication stop | G | 96.3 | - | 96.3 | 0.73 | 0.38, 1.00 | |
22 | Antidotes use | G | 98.2 | 0.66 | 0.03, 1.00 | 96.3 | 0.49 | -0.11, 1.00 |
23 | Adverse drug reaction | H | 98.2 | - | 100.0 | 1.00 | ||
24 | Decrease in hemoglobin or hematocrit of 25% or greater | G | 96.3 | 0.48 | -0.13, 1.00 | 100.0 | 1.00 | |
25 | Hypoglycemic symptom | G | 100.0 | 1.00 | 100.0 | - | ||
26 | Bleeding tendency | G | 100.0 | 1.00 | 100.0 | - | ||
27 | Rising BUN or serum creatine greater than 2 times baseline | G | 100.0 | - | 100.0 | - | ||
28 | Clostridium difficile positive stool1 | G | 100.0 | - | 100.0 | - | ||
29 | Post-op troponin level greater than upper normal limit1 | G | 100.0 | - | 100.0 | - | ||
30 | Mechanical ventilation greater than 24 hours post-op1 | G | 100.0 | - | 100.0 | - | ||
31 | Unplanned return to the operating theatre1 | H | 100.0 | - | 100.0 | - | ||
32 | Unplanned removal, injury or repair of organ during surgery | H | 100.0 | - | 100.0 | 1.00 | ||
33 | Intra-op epinephrine, norepinephrine, naloxone, or romazicon1 | G | 100.0 | - | 100.0 | - | ||
34 | Unplanned change in procedure or surgery1 | H | 100.0 | - | 100.0 | - | ||
35 | Intubation, reintubation, BiPap in post anesthesia care unit1 | G | 100.0 | - | 100.0 | - | ||
36 | X-ray in post anesthesia care unit1 | G | 100.0 | - | 100.0 | - | ||
37 | Terbutaline use in obstetrics | G | 98.2 | - | 100.0 | - | ||
38 | Oxytocic agents in obstetrics | G | 100.0 | 1.00 | 100.0 | 1.00 | ||
39 | Neonatal complications such as 5-minute Apgar score<6, or complication of abortion, amniocentesis or labor and delivery1 | H, G | 100.0 | - | 100.0 | - | ||
40 | Documentation or correspondence indicating litigation, dissatisfaction1 | H | 100.0 | - | 100.0 | - | ||
41 | Any other undesirable outcomes not covered above | H | 96.3 | -0.02 | -0.05, 0.01 | 94.5 | 0.70 | 0.37, 1.00 |
Second-stage review necessity | 77.8 | 0.54 | 0.31, 0.77 | 83.3 | 0.67 | 0.47, 0.87 |