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Testing a trigger tool as a method of detecting harm from medication errors in a UK hospital: a pilot study
Bryony Dean Franklin1, Sylvia Birch, Mike Schachter
1Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust and The School of Pharmacy, University of London Imperial College London, London, UK. Bryony.DeanFranklin@imperial.nhs.uk
The International Journal of Pharmacy Practice
|September 16, 2010
Summary
This study adapted a US adverse drug event (ADE) trigger tool for UK use. The tool showed low positive predictive value and sensitivity for identifying preventable ADEs, indicating further refinement is needed.
Area of Science:
- Pharmacovigilance
- Patient Safety
- Health Informatics
Background:
- Adverse drug events (ADEs) are a significant concern in healthcare.
- Existing trigger tools for ADE detection require adaptation for different healthcare systems.
- Accurate identification of preventable ADEs is crucial for improving patient safety.
Purpose of the Study:
- To adapt a US adverse drug event (ADE) trigger tool for UK clinical settings.
- To evaluate the positive predictive value (PPV) and sensitivity of the adapted tool in identifying preventable ADEs.
- To compare the tool's performance against comprehensive retrospective health record review.
Main Methods:
- An established US ADE trigger tool was modified for UK use.
- The adapted tool was retrospectively applied to 207 patient health records.
- Performance metrics (PPV, sensitivity) were calculated by comparing tool-identified ADEs with those found through full health record review.
Main Results:
- The adapted trigger tool identified 168 positive triggers in 61% of patients.
- A total of seven ADEs were detected, with a prevalence of 1.0% for preventable ADEs.
- The overall PPV for preventable ADEs was low (0.01), and sensitivity was 0.40 compared to health record review.
Conclusions:
- The adapted trigger tool identified some ADEs but requires further refinement to reduce false positives and enhance sensitivity.
- Retrospective health record review remains the gold standard for comprehensive identification of preventable ADEs.
- No efficiency gains were observed when using the trigger tool in this pilot study.
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