Development of a trigger tool to detect harm during haemodialysis

Fielding, Catherine; Rhodes, Carol; Chesterton, Lindsay J.; Fluck, Richard; Lambe, G.; Inacay, Geoff

doi:10.12968/jokc.2016.1.2.72

Cited by 6 publications

(8 citation statements)

References 12 publications

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“…This may be related to differences between patients over the two cycles or as a result of ongoing interventions. Our findings are similar to an adult HTT study, which also reported a significant reduction in the severity and harm rate of triggers [ 7 ]. However, it is important to highlight that the trigger rate per HD session observed in this paediatric HD population is higher than the study of an adult HD cohort, in which the trigger rate per session was 0.71.…”

Section: Discussionsupporting

confidence: 90%

“…An HD Trigger Tool (HTT) to detect and monitor harm events specific to HD has been developed for adults receiving in-centre HD in Derby, UK [ 7 ]. The adult HTT was discussed extensively at our departmental dialysis staff meeting, with input from dialysis nurse specialists.…”

Section: Methodsmentioning

confidence: 99%

“…

Fig. 1 The categorisation of each trigger for level of physical harm using the ‘per dialysis session’ paediatric Haemodialysis Trigger Tool (pHTT) adapted from the Derby HD Trigger Tool (HTT) [ 7 ]

Fig. 2 Example of the application of the ‘per dialysis session’ paediatric Haemodialysis Trigger Tool (pHTT) during a typical in-centre haemodialysis session.…”

Section: Methodsmentioning

confidence: 99%

“… The categorisation of each trigger for level of physical harm using the ‘per dialysis session’ paediatric Haemodialysis Trigger Tool (pHTT) adapted from the Derby HD Trigger Tool (HTT) [ 7 ] …”

Section: Methodsmentioning

confidence: 99%

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Developing a trigger tool to monitor adverse events during haemodialysis in children: a pilot project

et al. 2022

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Background We developed a paediatric haemodialysis trigger tool (pHTT) for application per haemodialysis (HD) session in children receiving intermittent in-centre HD and systematically monitored adverse events. Methods Single-centre quality improvement study performed over two 8-week cycles. Data collected prospectively using a ‘per-dialysis session’ pHTT tool including 54 triggers across six domains, adapted from a recently described haemodialysis trigger tool (HTT) for adults. Each trigger was evaluated for level of harm following assessment by two authors. Following a period of training, HD nurses completed the HTT at the end of each dialysis session. Results There were 241 triggers over 182 dialysis sessions, with 139 triggers in 91 HD sessions for 15 children, age range 28–205 months, over an 8-week period (first cycle) and 102 triggers in 91 HD sessions for 13 children, age range 28–205 months, over a further 8-week period (second cycle). After interventions informed by the pHTT, the harm rate per session was significantly reduced from 1.03 (94/91) to 0.32 (29/91), P < 0.001. There was a significant difference between the distribution of triggers by harm category (P < 0.001) and between the proportion of triggers across the various domains of the pHTT (P = 0.004) between the two cycles. No triggers were evaluated as causing permanent harm. Conclusions This pilot study demonstrates potential benefits of a bedside tool to monitor adverse events during haemodialysis in children. Thus, following interventions informed by the pHTT, the harm rate per session was significantly reduced. Under standard patient safety systems, the vast majority of triggers identified by the pHTT would remain unreported and perhaps lead to missed opportunities to improve patient safety. We propose the use of a paediatric HTT as part of standard care by centres providing HD to children in the future. Graphical Abstract A higher resolution version of the Graphical abstract is available as Supplementary information

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

“…

Fig. 2 Example of the application of the ‘per dialysis session’ paediatric Haemodialysis Trigger Tool (pHTT) during a typical in-centre haemodialysis session.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Developing a trigger tool to monitor adverse events during haemodialysis in children: a pilot project

et al. 2022

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“…Haemodialysis is a high risk treatment with many known associated adverse events (38), that may not be related to the cannulation procedure or the involvement in this research study. This can include, but is not limited to:  Hypotension +/-fainting or episodes of unconsciousness  Cramps  Fluid Imbalance  Electrolyte Imbalance  Hypoglycaemia  Cardiac events including MI, arrhythmias and cardiac arrest…”

Section: Confidentiality Statementmentioning

confidence: 99%