Adverse Events in Long-Term Care: A Mixed-Methods Systematic Review.

INTRODUCTION: Adverse events are a major patient safety concern in long-term care, where older people with complex health needs are particularly vulnerable. PURPOSE: The purpose of this mixed-methods systematic review was to systematically synthesize quantitative and qualitative evidence regarding the occurrence, outcomes, and associated risk factors of adverse events in long-term care settings. METHODS: A mixed-methods systematic review using a convergent integrated approach was conducted. RESULTS: One hundred studies were included. Falls were the most frequently reported adverse event, followed by medication errors, adverse drug events, and pressure injuries. Outcomes ranged from mild harm to death, with moderate harm most commonly reported. Risk factors were multifactorial, spanning patient, care process, team, and organizational domains, with mostly moderate consistency of evidence. CONCLUSIONS: Adverse events in long-term care are common and complex. Improving safety requires system-level, multicomponent interventions and more consistent reporting practices.