• homeHOME
  • 활동
  • 환자안전 연구

환자안전 연구

ㆍ 제목 A trigger tool to detect harm in pediatric inpatient settings
ㆍ 조회수 2417 ㆍ 등록일시 2015-06-09
ㆍ 첨부파일

A trigger tool to detect harm in pediatric inpatient settings

 2015 Jun;135(6):1036-42. doi: 10.1542/peds.2014-2152. Epub 2015 May 18.

Abstract

OBJECTIVES: 

An efficient and reliable process for measuring harm due to medical care is needed to advance pediatric patient safety. Several pediatric studies have assessed the use of trigger tools in varying inpatient environments. Using the Institute for Healthcare Improvement's adult-focused Global Trigger Tool as a model, we developed and pilot tested a trigger tool that would identify the most common causes of harm in pediatric inpatient environments.

METHODS: 

After formal training, 6 academic children's hospitals used this novel pediatric trigger tool to review 100 randomly selected inpatient records per site from patients discharged during the month of February 2012.

RESULTS: 

From the 600 patient charts evaluated, 240 harmful events ("harms") were identified, resulting in a rate of 40 harms per 100 patients admitted and 54.9 harms per 1000 patient days across the 6 hospitals. At least 1 harm was identified in 146 patients (24.3% of patients). Of the 240 total events, 108 (45.0%) were assessed to have been potentially or definitely preventable. The most common patient harms were intravenous catheter infiltrations/burns, respiratory distress, constipation, pain, and surgical complications.

CONCLUSIONS: 

Consistent with earlier rates of all-cause harm in adult hospitals, harm occurs at high rates in hospitalized children. Availability and use of an all-cause harm identification tool will establish the epidemiology of harm and will provide a consistent approach to assessing the effect of interventions on harms in hospitalized children.


http://www.ncbi.nlm.nih.gov/pubmed/25986015

http://pediatrics.aappublications.org/content/135/6/1036.long

이전글 Unplanned return to theater: A quality of care and risk management index?
다음글 Preventability of voluntarily reported or trigger tool–identified medication errors in a pediatric institution by information technology: a retrospective cohort study
비밀번호 입력 X
비밀번호
확인
TOP