Resources

Nosocomial pneumonia can be classified into various subtypes, the most common of which is aspiration pneumonia (Marik, 2011). Aspiration is defined as the misdirection of oropharyngeal or gastric contents into the larynx and lower respiratory tract. Aspiration pneumonia then results when orogastric secretions colonized with bacteria produce an infectious response in the lungs. Aspiration of sterile contents causes chemical inflammation or aspiration pneumonitis (Marik, 2011).

Hemorrhage or hemorrhagic anemia refers to anemia secondary to acute blood loss associated with a medical or surgical procedure. Bleeding is a potential complication of any surgical procedure, and the risk is proportional to the size and complexity of the surgery. High blood loss is associated with certain types of surgery such as cardiac and liver surgeries, certain orthopaedic procedures (such as hip replacement) and obstetric surgery. Mortality may be greatly increased when severe bleeding occurs during the operative procedure (National Institute for Health and Care Excellence (NICE), 2014).

Healthcare-associated infections result in a substantial burden of disease in Canadians, and are an important public health problem. They are also a burden on Canada's healthcare system and a barrier to timely access to care for all Canadians (Public Health Agency of Canada 2017, "Routine").While it is important to prevent, and control the spread of all infections, there are certain, antimicrobial resistant organisms that are more prevalent and pose a great risk in healthcare settings.

Complications following infusion, transfusion and therapeutic injection.

Postpartum hemorrhage is the leading cause of maternal death worldwide, with an estimated mortality rate of 140 000 per year, or one maternal death every four minutes. PPH occurs in five per cent of all deliveries and is responsible for a major part of maternal mortality. The majority of these deaths occur within four hours of delivery, which indicates that they are a consequence of the third stage of labour. Nonfatal PPH results in further interventions, such as uterine exploration, evacuation or surgical procedures. Other implications include: iron deficiency anemia, exposure to blood products, coagulopathy, and organ damage with associated hypotension and shock which has the potential to jeopardize future fertility (Leduc et al. 2018).

Medication incidents are defined as: "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer. Medication incidents may be related to professional practice, drug products, procedures, and systems, and include prescribing, order communication, product labeling/packaging/nomenclature, compounding, dispensing, distribution, administration, education, monitoring, and use" (ISMP Canada, Definitions 2016). Medication safety is a shared responsibility among the healthcare team members, staff, and organizational leadership.

Gastroenteritis is an inflammation of the lining of the stomach and intestines, causing an acute onset of severe vomiting and diarrhea (Centers for Disease Control and Prevention (CDC) 2010). Infections that cause gastrointestinal illness (GI) may be caused by a variety of agents including bacteria, viruses and protozoa. Outbreaks of infectious GI can be devastating and lead to significant increased costs, increased patient morbidity, and in some instances patient mortality. The most important characteristic of pathogens responsible for infectious gastroenteritis is their ability to be rapidly transmitted in healthcare settings among individuals who often are highly susceptible. Episodes of infectious gastroenteritis account for a significant proportion of all patients/residents/clients in healthcare settings who develop diarrhea with or without nausea and/or vomiting (Provincial Infection Control Network of British Columbia 2016).

Lacerations are common after vaginal birth. Trauma can occur on the cervix, vagina, and vulva, including the labial, periclitoral, and periurethral regions, and the perineum (American College of Obstetricians and Gynecologists (ACOG), 2018). A woman's safety during childbirth can be assessed by looking at potentially avoidable tearing of the perineum (Organization for Economic Co-operation and Development (OECD), 2019) and other obstetrical injuries to the pelvic organs during vaginal deliveries. While it is not possible to prevent these types of tears in all cases, they can be reduced by appropriate labour management and high-quality obstetric care (OECD, 2019).

A pneumothorax is present when there is air in the pleural space. Pneumothoraces are classified as spontaneous, which develop without preceding trauma or other obvious cause, and traumatic, which develop as a result of direct or indirect trauma to the chest. Traumatic pneumothoraces can be either iatrogenic or non-iatrogenic (Light & Lee, 2016). An iatrogenic pneumothorax (IP) is a known complication of invasive procedures such as pulmonary needle biopsy (transthoracic and transbronchial), placement of a central venous line, or positive pressure ventilation. However, this condition can arise from many other procedures involving the thorax and abdomen. Subclavian insertion of a central venous line (CVL) is the most common procedure associated with an iatrogenic pneumothorax (Ojeda Rodriguez & Hipskind, 2021) and is the focus of this indicator.