Serious Adverse Event Narrative Writing: A Comprehensive Review

This essay provides a detailed overview of serious adverse event narrative writing, emphasizing its importance in healthcare. It defines serious adverse events as those that result in death, are life-threatening, cause significant disability, or result in birth defects, necessitating immediate intervention. The essay distinguishes between anticipated and unanticipated adverse events, highlighting the critical need to report unanticipated events due to their unexpected nature. It addresses the challenges associated with serious adverse event narrative writing, including data resource intensity, consistency requirements, and turnaround time pressures. The essay also references international guidelines and reports on incidents in countries like New Zealand to underscore the importance of adhering to standard operating procedures (SOPs) to enhance patient safety and improve healthcare outcomes. The conclusion advocates for a critical approach to adverse events, learning from past mistakes, and adopting best practices to ensure patient safety and cost-effective medical services.

Running Head: SERIOUS ADVERSE EVENT NARRATIVE WRITING
Serious adverse event narrative writing
Essay
Student Name

SERIOUS ADVERSE EVENT NARRATIVE WRITING 1
Introduction
Narrative writing is actually an overall summary of some events that a patient has
experienced during his/her clinical treatment. This consists of patient profile and proper
collection of related data. While serious adverse event writing is actually a detailed document
which consists of detail of all sequence events that has happened, includes the character of
the patient, therapy given to the patient, medical details, and diagnosis. It basically meets
some criteria: death, life-threatening, significant disability and birth defect. It is an event that
requires intervention to avoid permanent damage inpatient case. This report must be given
within the 24 hours of the happened event.
Serious adverse event narrative writing
As mentioned that serious adverse event narrative writing is a kind of summary covering the
total detail of the patient right from his entry in the hospital till the patient leaves the hospital
which includes personal details, medical procedure applied and also the level of the
seriousness of the patient (1). The adverse event basically covers two events. One is
anticipated in which reason and occurrence are known and other is unanticipated in which
reason and occurrence are unknown or unidentified/unexpected. Usually anticipated is
recorded as expected, while unanticipated is reported because it includes sudden death or
unexpected disability or life-threatening. So, these are a very serious event in medical trials
which is needed to be reported (2).
According to world health organization, it has been found out that the patients who visit the
hospital for some service related to their issue may have faced one or two adverse events.The
events can be of minor, moderate or of major nature which increases the spending time of the
patient in the hospital along with the increasing cost in the hospitalization (3). Serious
adverse event narrative writing is not an easy task; it is a highly challenging task because it
requires a large number of data resources, a lot of consistency has to be maintained,
turnaround time is also of very important along with the delivery with high quality, lack of
available standard data, process review should maintain an SOP (4). According to
International conference on harmonization, serious adverse events must be given first priority
as compared to other events and the patient should be taken under individual consideration
until the patient is present in the hospital. It has been found in many cases that the data
related to the report has been manipulated for the safety and security of the hospital or clinic.
Proper investigation is being conducted on the SAE trying to find out what are the causes that
have given birth to such events. After the cause is known then necessary steps are been taken
to avoid the repeated occurrence of such events in near future (5). The main purpose of
conducting such investigation is to improve the health of the people and to adopt learning
from such events which can be better utilised in the health safety of the common people and
also should not blame an individual person for the happening of such events.
Such events had happened in many countries. Let us take the incidents happened in South
DHB (2014-15). It had been seen that 31% - Clinic process (Incident happened during
assessment, diagnosis, and treatment), 29% - patient fall, 23%- clinic administrative incident

SERIOUS ADVERSE EVENT NARRATIVE WRITING 2
process (Incident happened during handover, referral and discharge), 8% - medical events
(Patient was given wrong medicine or not given prescribed dose ) and 3% - medical
instruments ( Incident happened due to failure of instrument). Finding from fall events was
that confusion of patient was there in which individual care plan was not completed, delay in
reading x-ray report, last remove of fall alarm by the patient, patient mobilized to the toilet
without the assistant and hard floor may also be contributed. Finding from clinic
administration was that lack of quality in the process which informs that care is being taken
with time, service planning was not proper, lack of development in instruments as well as the
development of team members due to lack of available fund and delay in the treatment
process (6).
The same Event happened before in 2012-2013 in South DHB. It had been seen that 40%-
Clinic process (due to general care, treatment, and assessment), 11% - clinic administrative
incident (due to handover, discharge and referral), medical events - 6% (given wrong
medicine) and healthcare acquired infection- 9% and 3% absence without leave. Finding
from this report was that x-ray recommended for the patient for CT scan was not done on
the needed time, delay was made in treating cancer because lack of referral, patient
appointment was not arranged after the surgery and no proper monitoring was done which
leads towards cardiopulmonary arrest, failure to follow the chemotherapy plan which resulted
in unexpected result, misinterpretation of X-ray, missed diagnosis of pregnancy which leads
emergency situation, wrong side surgery and medication errors (7). As per report 2016-2017,
New Zealand is the one of the world leading country in case of medical health. No doubt this
country charge the high cost for medical health services but their medical service is one of the
best services in the world with very less count of serious adverse event occurrence leaving
behind the United States and the United Kingdom for away. In this country, there is the
systematic procedure for medical service which is carried in a recommended standard of
procedure (8).

SERIOUS ADVERSE EVENT NARRATIVE WRITING 3
Conclusion
Serious adverse events in medical services should be taken very critically and the mistakes
which happened in previous time should not be repeated again because if such mistakes
happened again, then it will be very risky for the life of the patient. As we have found that
New Zealand is the only country which strictly follows the SOP given by WHO as compared
to other countries and this becomes the reason why medical services of this country are better
than worlds other countries. So, if the world wants an environment full of health safety
leaving the risk behind then they have to follow this SOP which will provide health safety
along with cost-effective medical service.

SERIOUS ADVERSE EVENT NARRATIVE WRITING 4
References
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health professionals. Revista da Associação Médica Brasileira.2013; 59(6):629-638.
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Walkup M.P, Nadkarni N, Pahor M, Gill T.M., Quagliarello V. Serious adverse
events of older adults in nursing home and community intervention
trials. Contemporary Clinical Trials Communications. 2017: 9: 77-80
3. Gutiérrez-Mendoza L.M , Torres-Montes A, Soria-Orozco M, Padrón-Salas A,
Ramírez-Hernández M.E. Costs of serious adverse events in a community teaching
hospital, in Mexico. Cirugía y Cirujanos (English Edition). 2015; 83(3): 211-216.
4. Ledade S.D, Jain S.N, Darji A.A, Gupta V.H. Narrative writing: Effective ways and
best practices. Perspectives in clinical research.2017; 8(2):58.
5. Wang T, Collet J.P, Shapiro S ,Ware M.A. Adverse effects of medical cannabinoids: a
systematic review. Canadian Medical Association Journal. 2008; 178(13):1669-1678.
6. SDHB. Serious Adverse Events 2014-2015 [Internet].2015 [cited 15/6/18]. Available
from:https://www.southerndhb.govt.nz/files/16441_20151204114702-
1449182822.pdf
7. SDHB. Serious Adverse Events 2012-2013[Internet]. 2013 [cited 15/6/18]. Available
from:https://www.southerndhb.govt.nz/files/11525_20131121115146-
1384987906.pdf
8. DHB. Annualreport-2016/17 [Internet]. 2017 [cited 15/6/18]. Available from:
http://www.waitematadhb.govt.nz/assets/Documents/annual-Reports/Waitemata-
DHB-2016-2017-Annual-Report.pdf