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Gonzalez Delgado M, Cortes Gil JD, Rodriguez Araujo DL, Mira Solves JJ, Rodriguez Gallo EB, Salcedo Monsalve A, Arrieta Arteta LA, Villalba Toquica CDP, Morales Ruiz JC. Acute Stress in Health Workers in Colombia 2017-2021: A Cross-Sectional Study. Int J Public Health 2023; 68:1606274. [PMID: 37719659 PMCID: PMC10502716 DOI: 10.3389/ijph.2023.1606274] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/16/2023] [Indexed: 09/19/2023] Open
Abstract
Objectives: Analyze the presence of acute stress response after adverse events in human talent in Colombian health institutions from 2017 to 2021. Methods: Cross-sectional study of prevalence, carried out on 838 members of the human talent in health (professionals, technicians, technologists, and auxiliaries) of Colombian health institutions in the study period with the application of the EASE instrument. Univariate analysis using descriptive statistical techniques, chi-square and Student's t-test, and bivariate analysis with a Poisson regression model using the institucional SPSS v. 26. Results: The prevalence of adverse events in the last 5 years was 33.8%, presenting levels of acute stress qualifying as Medium-high emotional overload at 21.91%, while extreme acute stress was at 3.53%. The prevalence of risk for presenting acute stress after being involved in an adverse event was PR: 1.30 (CI: 1.24-1.36). Conclusion: Acute stress in human talent after adverse events is limiting health and care capacity and must be efficiently addressed by health institutions. Psychosocial risk is linked within the framework of the patient safety program and the institutional occupational health and safety management systems.
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Affiliation(s)
- Mery Gonzalez Delgado
- Facultad de Ciencias de la Salud y del Deporte, Especialización en Auditoría en Salud y Red Interprofesional Colombiana de Seguridad del Paciente, Fundación Universitaria del Área Andina, Bogotá, Colombia
| | - Jesus David Cortes Gil
- NOVA National School of Public Health, Public Health Research Center, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | - Deysy Lisette Rodriguez Araujo
- Facultad de Ciencias de la Salud y del Deporte, Especialización en Auditoría en Salud, Fundación Universitaria del Área Andina, Bogotá, Colombia
| | | | - Erika Bibiana Rodriguez Gallo
- Facultad de Ciencias de la Salud y del Deporte, Especialización en Auditoría en Salud, Fundación Universitaria del Área Andina, Bogotá, Colombia
| | - Alejandra Salcedo Monsalve
- Facultad de Ciencias de la Salud y del Deporte, Programa de Medicina, Fundación Universitaria del Área Andina, Bogotá, Colombia
| | - Luz Angela Arrieta Arteta
- Facultad de Ciencias de la Salud y del Deporte, Programa de Medicina, Fundación Universitaria del Área Andina, Bogotá, Colombia
| | | | - Juan Carlos Morales Ruiz
- Red Iberoamericana de Conocimiento en Seguridad del Paciente, Red Salud Colsubsidio, Bogotá, Colombia
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Lima Júnior AJD, Zanetti ACB, Dias BM, Bernardes A, Gastaldi FM, Gabriel CS. Occurrence and preventability of adverse events in hospitals: a retrospective study. Rev Bras Enferm 2023; 76:e20220025. [PMID: 37436233 DOI: 10.1590/0034-7167-2022-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 01/17/2023] [Indexed: 07/13/2023] Open
Abstract
OBJECTIVES to analyze the incidence of preventable adverse events related to health care in adult patients admitted to public hospitals in Brazil. METHODS observational, analytical, retrospective study based on medical records review. RESULTS medical records from 370 patients were evaluated, 58 of whom had at least one adverse event. The incidence of adverse events corresponded to 15.7%. Adverse events were predominantly related to healthcare-related infection (47.1%) and procedures (24.5%). Regarding the adverse event severity, 13.7% were considered mild, 51.0% moderate, and 35.3% severe. 99% of adverse events were classified as preventable. Patients admitted to the emergency room had a 3.73 times higher risk for adverse events. CONCLUSIONS this study's results indicate a high incidence of avoidable adverse events and highlight the need for interventions in care practice.
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Bocanegra Rivera JC, Gómez Buitrago LM, Sánchez Bello NF, Chaves Vega A. Adverse events in anesthesia: Analysis of claims against anesthetists affiliated to an insurance fund in Colombia. Cross-sectional study. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2022. [DOI: 10.5554/22562087.e1043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: Prevention, identification, analysis and reduction of adverse events (AEs) are all activities designed to increase safety of care in the clinical setting. Closed claims reviews are a strategy that allows to identify patient safety issues. This study analyzes adverse events resulting in malpractice lawsuits against anesthesiologist affiliated to an insurance fund in Colombia between 2013-2019.
Objective: To analyze adverse events in closed medicolegal lawsuits against anesthesiologist affiliated to an insurance fund between 2013-2019.
Methods: Cross-sectional observational study. Convenience sampling was used, including all closed claims in which anesthesiologist affiliated to an insurance fund in Colombia were sued during the observation period. Variables associated with the occurrence of AEs were analyzed.
Results: Overall, 71 claims were analyzed, of which 33.5% were due to anesthesia-related AEs. Adverse events were found more frequently among ASA I-II patients (78.9%), and in surgical procedures (95.8%). The highest number of adverse events occurred in plastic surgery (29.6%); the event with the highest proportion was patient death (43.7%). Flaws in clinical records and failure to comply with the standards were found in a substantial number of cases.
Conclusions: When compared with a previously published study in the same population, an increase in ethical, disciplinary and administrative claims was found, driven by events not directly related to anesthesia. Most of the anesthesia-related events occurred in the operating theater during surgical procedures in patients and procedures categorized as low risk, and most of them were preventable.
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Surgery Is in Itself a Risk Factor for the Patient. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084761. [PMID: 35457626 PMCID: PMC9026870 DOI: 10.3390/ijerph19084761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/03/2022] [Accepted: 04/04/2022] [Indexed: 02/04/2023]
Abstract
(1) Background: Adverse events (AE) affect about 1 in 10 hospitalised patients, and almost half are related to surgical care. The aim of this study is to determine the prevalence of AE in operated and non-operated patients in surgical departments in order to determine whether surgical treatment is a risk factor for AE. (2) Methods: A cross-sectional design that included 3123 patients of 34 public hospitals in the Community of Madrid determining the prevalence of AEs in operated and non-operated patients in surgical departments. (3) Results: The prevalence of AE in non-operated patients was 8.7% and in those operated was 15.8%. The frequency of AE was higher in emergency surgery (20.6% vs. 12.4%). The 48.3% of AEs led to an increase in hospital stay, and surgery was involved in 92.4% of cases. The most frequent AEs were related to hospital-acquired infection (42.63%), followed by those related to a procedure (37.72%). In the multivariate analysis, being operated on represented 2.3 times the risk of developing an AE. (4) Conclusions: Surgical sites are particularly vulnerable to AE. Surgical intervention alone is a risk factor for AE, and we must continue to work to improve the safety of both patient care and the working environment of surgical professionals.
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Valencia-Martín JL, Martin-Delgado J, Pardo-Hernández A, Vicente-Guijarro J, Requena-Puche J, Aranaz Andrés JM. The Study on Safety in Hospitals in the Region of Madrid (ESHMAD) design: Screening and analysis of incidents and adverse events. J Healthc Qual Res 2021; 36:231-239. [PMID: 33967001 DOI: 10.1016/j.jhqr.2021.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/25/2021] [Accepted: 03/18/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND A Study related to Safety in Hospitals in the Region of Madrid (ESHMAD) was carried out in order to determine the prevalence, magnitude and characteristics of adverse events in public hospitals. This work aims to define a useful methodology for the multicenter study of adverse events in the Region of Madrid, to set out the preliminary results of the hospital enrollment and to establish a model of a strategy of training of trainers for its implementation. METHODS ESHMAD was a multicenter, double phase study for the estimation of adverse events and incidents prevalence across the Region of Madrid. First phase comprehended a 1-day cross-sectional prevalence study, in which it was collected, through a screening guide, information about admission, patient characteristics, intrinsic and extrinsic risk factors, and the possibility of an adverse event or incident had happened during the hospitalization. Second phase was a retrospective nested cohort study, in which it was used a Modular Review Form for reviewing the positive screenings of the first phase, identifying in each possible adverse event or incident the classification of the patient safety event, clinical onset, root, and associated causes and factors, impact, and preventability. A pilot study was performed in an Internal Medicine Unit of a tertiary hospital. RESULTS 34 public hospitals participated, belonging to 6 healthcare categories and with more than 10,000 hospitalisations aggregate capacity. 72 coordinators were enrolled in the strategy of training of trainers, which was performed through five on-site training workshops. In the pilot study, 45.2% patients were identified with at least one positive event of the screening. Of them, 48.1% (25 positive events) were identified as truly AE, with a result of 0.29 EA per analyzed patient. CONCLUSIONS The ESHMAD protocol allows to estimate the prevalence of adverse events, and the strategy of training of trainers facilitated the spread of the research methodology among the participants.
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Affiliation(s)
- J L Valencia-Martín
- Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - J Martin-Delgado
- Atenea Research Group, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO), 46035 Valencia, Spain; Health Services & Policy Research Group, University of Exeter, EX1 2LU Exeter, United Kingdom
| | - A Pardo-Hernández
- Subdirección General de Calidad Asistencial y Cooperación Sanitaria, Consejería de Sanidad de la Comunidad de Madrid, 28013 Madrid, Spain; Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, 28933, Madrid, Spain
| | - J Vicente-Guijarro
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain.
| | - J Requena-Puche
- Hospital General Universitario de Elda, 03600 Alicante, Spain; Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández de Elche, 03202 Elche, Alicante, Spain
| | - J M Aranaz Andrés
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
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[An analysis of medication errors in patients admitted to surgery rooms and post-anesthetic recovery at a high-complexity hospital in Bogota, Colombia]. Salud Colect 2021; 17:e3155. [PMID: 34105334 DOI: 10.18294/sc.2021.3155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 03/01/2021] [Indexed: 11/24/2022] Open
Abstract
Medication errors represent one of the main causes of incidents and adverse events during the perioperative period. Therefore, this study analyzes errors before, during, and after the administration of general anesthesia for abdominal surgery at a high-complexity hospital in Bogota, Colombia. A descriptive cross-sectional study was conducted with 390 patients between January and September 2019. Of the 3,677 medication administrations, some type of error was made in 60% of cases, mostly in emergency surgeries. The pharmacological group with the most errors was general anesthetics, with 32%. All identified errors constituted situations with harm potential, indicating the need to promote the standardization of activities involving the use of medications and a culture of healthcare safety in order to avoid adverse events.
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[Critically ill patient isolation: risk or protection?]. J Healthc Qual Res 2018; 33:250-255. [PMID: 30401420 DOI: 10.1016/j.jhqr.2018.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 06/20/2018] [Accepted: 06/26/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Isolation precautions are an effective measure to prevent the spread of multi-resistant microorganisms (MMR). However, its implementation is complex and can increase some risks to the patient. The aim of this study is to determine whether the implementation of isolation precautions increase the risk of patient safety incidents (PSI) in critically ill patients. MATERIAL AND METHODS A retrospective observational study was conducted involving patients admitted to the ICU of a University Hospital, and that required isolation for more than 48h. Period of study: two years (from 2013/03/01 to 2015/03/31). Data source was the electronic medical record. The tools for evaluation were the Modular Review Form questionnaires (MRF1 and MRF2). An analysis was made of PSI and adverse events (AEs) during periods with and without isolation precautions, including the PSI type, severity, and preventability. RESULTS The study included a total of 76 patients, 74 of whom had at least one PSI. A total of 798 PSI were detected (511 during isolation period), 599 were a No harm incident (NHI) and 199 were adverse AEs. The most frequent PSIs were associated with medication (316) and patient health care (279). Most of them were moderately or highly preventable. The incidence of PSI during periods with and without isolation was 27.3 (SD 33.8) and 29 (39.6) per 100 patient-days, respectively. CONCLUSIONS PSIs in ICU are frequent, and the most of them are preventable. The adoption of isolation precautions does not constitute a risk factor for PSI. Improving patient safety culture is essential for an adequate prevention strategy.
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Aranaz Andrés JM, Limón Ramírez R, Aibar Remón C, Gea-Velázquez de Castro MT, Bolúmar F, Hernández-Aguado I, López Fresneña N, Díaz-Agero Pérez C, Terol García E, Michel P, Sousa P, Larizgoitia Jauregui I. Comparison of two methods to estimate adverse events in the IBEAS Study (Ibero-American study of adverse events): cross-sectional versus retrospective cohort design. BMJ Open 2017; 7:e016546. [PMID: 28993382 PMCID: PMC5640028 DOI: 10.1136/bmjopen-2017-016546] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Adverse events (AEs) epidemiology is the first step to improve practice in the healthcare system. Usually, the preferred method used to estimate the magnitude of the problem is the retrospective cohort study design, with retrospective reviews of the medical records. However this data collection involves a sophisticated sampling plan, and a process of intensive review of sometimes very heavy and complex medical records. Cross-sectional survey is also a valid and feasible methodology to study AEs. OBJECTIVES The aim of this study is to compare AEs detection using two different methodologies: cross-sectional versus retrospective cohort design. SETTING Secondary and tertiary hospitals in five countries: Argentina, Colombia, Costa Rica, Mexico and Peru. PARTICIPANTS The IBEAS Study is a cross-sectional survey with a sample size of 11 379 patients. The retrospective cohort study was obtained from a 10% random sample proportional to hospital size from the entire IBEAS Study population. METHODS This study compares the 1-day prevalence of the AEs obtained in the IBEAS Study with the incidence obtained through the retrospective cohort study. RESULTS The prevalence of patients with AEs was 10.47% (95% CI 9.90 to 11.03) (1191/11 379), while the cumulative incidence of the retrospective cohort study was 19.76% (95% CI 17.35% to 22.17%) (215/1088). In both studies the highest risk of suffering AEs was seen in Intensive Care Unit (ICU) patients. Comorbid patients and patients with medical devices showed higher risk. CONCLUSION The retrospective cohort design, although requires more resources, allows to detect more AEs than the cross-sectional design.
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Affiliation(s)
- Jesus Maria Aranaz Andrés
- Department of Preventive Medicine and Public Health, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Center of Biomedical Network Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Ramóny Cajal Biomedical Research Institute (IRYCIS), Madrid, Spain
- La Rioja International University (UNIR), Logroño, Spain
| | - Ramon Limón Ramírez
- Department of Preventive Medicine and Quality of Healthcare, Hospital de la Plana, Castellón, Spain
| | - Carlos Aibar Remón
- Department of Preventive Medicine and Public Health, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
- Aragón Healthcare Research Institute (IIS), Zaragoza, Spain
| | - Maria Teresa Gea-Velázquez de Castro
- Department of Preventive Medicine and Quality of Healthcare, Hospital Universitari Sant Joan d’Alacant, Sant Joan d’Alacant, Spain
- Department of Public Health, Science, History and Gynaecology, Miguel Hernández University, Sant Joan d’Alacant, Spain
| | - Francisco Bolúmar
- Center of Biomedical Network Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Unit of Public Health, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Ildefonso Hernández-Aguado
- Center of Biomedical Network Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Public Health, Science, History and Gynaecology, Miguel Hernández University, Sant Joan d’Alacant, Spain
| | - Nieves López Fresneña
- Department of Preventive Medicine and Public Health, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Ramóny Cajal Biomedical Research Institute (IRYCIS), Madrid, Spain
- La Rioja International University (UNIR), Logroño, Spain
| | - Cristina Díaz-Agero Pérez
- Department of Preventive Medicine and Public Health, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Ramóny Cajal Biomedical Research Institute (IRYCIS), Madrid, Spain
- La Rioja International University (UNIR), Logroño, Spain
| | | | - Philippe Michel
- Centre Hospitalier Universitaire de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Paulo Sousa
- Universidade Nova de Lisboa, Escola Nacional de Saude Publica. Centro deInvestigação em Saúde Pública-UNL, Lisboa, Portugal
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Caracterización y análisis de eventos adversos en procesos cerrados de anestesiólogos apoderados por la Sociedad Colombiana de Anestesiología y Reanimación (S.C.A.R.E.) en Colombia entre 1993 y 2012. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2016. [DOI: 10.1016/j.rca.2016.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Characterization and analysis of adverse events in closed liability cases involving anaesthetists who received legal support from the Colombian Society of Anaesthesia and Resuscitation (S.C.A.R.E.), Colombia, 1993-2012☆. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2016. [DOI: 10.1097/01819236-201644030-00004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Orozco-Arbeláez A, Flórez DM, Molina-Rúa G, Meneses-Arango JA. Aspectos de no calidad en neumonía asociada al uso de ventilador en una Unidad de Cuidados Intensivos de Medellín, 2012. REVISTA FACULTAD NACIONAL DE SALUD PÚBLICA 2015. [DOI: 10.17533/udea.rfnsp.v34n1a09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Manrique BT, Soler LM, Bonmati AN, Montesinos MJL, Roche FP. Segurança do paciente no centro cirúrgico e qualidade documental relacionadas à infecção cirúrgica e à hospitalização. ACTA PAUL ENFERM 2015. [DOI: 10.1590/1982-0194201500060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objetivo Descrever a qualidade documental de dois registros relacionados à segurança de pacientes no centro cirúrgico e estabelecer as diferenças nas informações relacionadas à infecção cirúrgica e à permanência hospitalar. Métodos Estudo comparativo baseado em dois cortes transversais, realizado com 3.033 pacientes internados há mais de 24 horas, advindos de Cirurgia Ortopédica e Traumatologia. Foram comparados dados sociodemográficos, clínicos e de preenchimento. Mediu-se a infecção pós-cirúrgica como um evento adverso. Resultados Houve correlação significativa entre os dias de hospitalização e o número total de diagnósticos coletados (Pearson=0,328; p<0,001). Quando se agruparam os diagnósticos e a infecção, notou-se um valor significativo entre as fraturas fechadas e a infecção (p=0,001). Conclusão Foram observadas diferenças no grau de preenchimento entre os dois registros. Não houveram diferenças no evento adverso.
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Identificación de eventos adversos en pacientes hospitalizados por gripe. ACTA ACUST UNITED AC 2015; 30:17-23. [DOI: 10.1016/j.cali.2015.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 12/29/2014] [Accepted: 01/07/2015] [Indexed: 11/24/2022]
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