Measuring adverse events in pediatric inpatients with the Global Trigger Tool

Davenport, Carolina; Domínguez, Paula; Ferreira, Juan Pablo; Kannemann, Ana; Paganini, Agustina; Torres, Fernando

doi:10.5546/aap.2017.eng.357

Cited by 5 publications

(3 citation statements)

References 16 publications

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“…In total, 108 publications underwent full text screening, including four publications from reference lists. After assessment of eligibility, 64 publications were excluded and 44 publications8 11–14 33 38–75 of 32 unique studies8 11 12 14 33 38–42 45 48–50 53 55 57–68 71–74 were included (online supplemental material 1, figure S1). As one study55 reported outcomes for both populations, a total of 33 samples were included, 22 for the general care and 11 for intensive care populations.…”

Section: Resultsmentioning

confidence: 99%

Incidence and characteristics of adverse events in paediatric inpatient care: a systematic review and meta-analysis

et al. 2022

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BackgroundAdverse events (AEs) cause suffering for hospitalised children, a fragile patient group where the delivery of adequate timely care is of great importance.ObjectiveTo report the incidence and characteristics of AEs, in paediatric inpatient care, as detected with the Global Trigger Tool (GTT), the Trigger Tool (TT) or the Harvard Medical Practice Study (HMPS) method.MethodMEDLINE, Embase, Web of Science and Google Scholar were searched from inception to June 2021, without language restrictions. Studies using manual record review were included if paediatric data were reported separately. We excluded studies reporting: AEs for a specific disease/diagnosis/treatment/procedure, or deceased patients; study protocols with no AE outcomes; conference abstracts, editorials and systematic reviews; clinical incident reports as the primary data source; and studies focusing on specific AEs only. Methodological risk of bias was assessed using a tool based on the Quality Assessment Tool for Diagnostic Accuracy Studies 2. Primary outcome was the percentage of admissions with ≥1 AEs. All statistical analyses were stratified by record review methodology (GTT/TT or HMPS) and by type of population. Meta-analyses, applying random-effects models, were carried out. The variability of the pooled estimates was characterised by 95% prediction intervals (PIs).ResultsWe included 32 studies from 44 publications, conducted in 15 countries totalling 33 873 paediatric admissions. The total number of AEs identified was 8577. The most common types of AEs were nosocomial infections (range, 6.8%–59.6%) for the general care population and pulmonary-related (10.5%–36.7%) for intensive care. The reported incidence rates were highly heterogeneous. The PIs for the primary outcome were 3.8%–53.8% and 6.9%–91.6% for GTT/TT studies (general and intensive care population). The equivalent PI was 0.3%–33.7% for HMPS studies (general care). The PIs for preventable AEs were 7.4%–96.2% and 4.5%–98.9% for GTT/TT studies (general and intensive care population) and 10.4%–91.8% for HMPS studies (general care). The quality assessment indicated several methodological concerns regarding the included studies.ConclusionThe reported incidence of AEs is highly variable in paediatric inpatient care research, and it is not possible to estimate a reliable single rate. Poor reporting standards and methodological differences hinder the comparison of study results.

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Section: Resultsmentioning

confidence: 99%

Incidence and characteristics of adverse events in paediatric inpatient care: a systematic review and meta-analysis

et al. 2022

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“…The GTT was originally developed for adult hospital inpatients. Thereafter, trigger tools to detect adverse events have been adapted and modified for hospital specialties such as pediatric care [ 50 ] and home healthcare [ 36 ]; similar adaption and modification could be applied to obstetric care.…”

Section: Discussionmentioning

confidence: 99%

Adverse events in women giving birth in a labor ward: a retrospective record review study

Skoogh

Hall‐Lord

Bååth

et al. 2021

BMC Health Serv Res

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Background Childbirth could negatively affect the woman’s health through adverse events. To prevent adverse events and increase patient safety it is important to detect and learn from them. The aim of the study was to describe adverse events, including the preventability and severity of harm during planned vaginal births, in women giving birth in the labor ward. Methods The study had a descriptive design with a retrospective birth record review to assess the preventability of adverse events using the Swedish version of the Global Trigger Tool. The setting was a labor ward in Sweden with low-risk and risk childbirths. Descriptive statistics, Pearson’s Chi-square test and Student’s t-test were used. Results A total of 38 adverse events (12.2%) were identified in 311 reviewed birth records. Of these, 28 (73.7%) were assessed as preventable. Third- or fourth-degree lacerations and distended urinary bladder were most prevalent together with anesthesia-related adverse events. The majority of the adverse events were classified into the harm categories of ‘prolonged hospital care’ (63.2%) and ‘temporary harm’ (31.6%). No permanent harm were identified, but over two-thirds of the adverse events were assessed as preventable. Conclusions This first study using Global Trigger Tool in a labor ward in Sweden identified a higher incidence of adverse events than previous studies in obstetric care. No permanent patient harm was found, but over two-thirds of the adverse events were assessed as preventable. The results draw particular attention to 3rd-or 4th-degree lacerations, distended urinary bladder and anesthesia-related adverse events. The feedback on identified adverse events should be used for systematic quality improvement and clinical recommendations how to prevent adverse events must be implemented.

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“…In pediatric healthcare, AEs pose significant challenges, with studies reporting varying rates depending on patient populations and settings [7][8][9]. PAEs have been linked to substantial morbidity and mortality, with certain patient groups at higher risk [7].…”

Section: Introductionmentioning

confidence: 99%

Hospital and Patient Characteristics Associated with Neonatal Blood Stream Infection in Inpatient Hospital Care; Healthcare Cost and Utilization Project (HCUP) Kids’ Inpatient Databases (KID) 2019

Samawi,

Shah,

Kimsey

et al. 2024

Preprint

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This study aims to explore the associations between pediatric adverse events (PAEs) and hospital and patient characteristics within the inpatient hospital setting, focusing solely on the framework of pediatric quality indicators (PDIs) from the Agency for Healthcare Research and Quality (AHRQ). Specifically, the study focuses on NQI 03 Neonatal Blood Stream Infection (NBSI). The analysis utilizes discharge data from the Healthcare Cost and Utilization Project (HCUP) Kids’ Inpatient Databases (KID) for the year 2019. Through this analysis, the study seeks to answer research questions regarding associations between hospital characteristics and patient characteristics with NQI 03. The methodology employs bivariate and multivariate logistic regression models to analyze patient-level encounters of NBSI. The results indicate that smaller, rural, and non-teaching hospitals exhibit significantly lower odds of NQI 03 compared to large hospitals. Various individual factors such as gender, age, race, service lines, payment sources, and major operating room procedures also demonstrate differing levels of significance in relation to NQI 03, warranting further investigation. This study provides contextual expansion on the findings and offers valuable insights into PAEs in the inpatient hospital setting, specifically focusing on NBSI within the PDIs framework. It highlights areas for developing evidence-based interventions and guidelines for clinicians and policymakers. Ultimately, the findings contribute to the growing understanding of factors influencing NBSI and emphasize the importance of targeted strategies for improving pediatric patient safety.

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Measuring adverse events in pediatric inpatients with the Global Trigger Tool

Abstract: An AE frequency of 26% was identified, and most AEs resulted in temporary harm. The presence of AEs was associated to hospitalization in a closed unit, longer hospital stay, higher number of triggers and general care triggers.

Cited by 5 publications

References 16 publications

Incidence and characteristics of adverse events in paediatric inpatient care: a systematic review and meta-analysis

Incidence and characteristics of adverse events in paediatric inpatient care: a systematic review and meta-analysis

Adverse events in women giving birth in a labor ward: a retrospective record review study

Hospital and Patient Characteristics Associated with Neonatal Blood Stream Infection in Inpatient Hospital Care; Healthcare Cost and Utilization Project (HCUP) Kids’ Inpatient Databases (KID) 2019

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