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The Trigger Tool as a Method to Measure Harmful Medication Errors in Children.

Jolanda M Maaskant, Marian Smeulers1, Diederik Bosman

  • 1Department of Quality Assurance and Process Innovation, and.

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Summary

A pediatric medication-focused trigger tool failed to detect harmful medication errors (MEs) in children. A multifaceted method is more effective for identifying unsafe situations and improving medication safety.

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Area of Science:

  • Pediatric Patient Safety
  • Medication Error Detection
  • Healthcare Quality Improvement

Background:

  • Medication errors (MEs) pose a significant risk to pediatric patient safety.
  • Quantifying preventable MEs is crucial for improving care.
  • Trigger tools are proposed as efficient methods for ME detection, but their performance needs evaluation.

Purpose of the Study:

  • To evaluate the performance of a pediatric medication-focused trigger tool in identifying harmful medication errors.
  • To compare the effectiveness of a trigger tool against a multifaceted method for ME detection.

Main Methods:

  • A multifaceted method was established as the reference standard for detecting harmful MEs.
  • A pediatric medication-focused trigger tool was compared against the multifaceted method in a cohort of 369 pediatric patients.
  • Data collection was conducted by separate, blinded teams to ensure objectivity.

Main Results:

  • The multifaceted method identified 33 harmful MEs.
  • The original trigger tool failed to detect any harmful MEs.
  • An extended trigger tool, including pain and nausea/vomiting symptoms, identified 19 harmful MEs, with a sensitivity of 21.2% and a positive predictive value of 36.8%.

Conclusions:

  • The original pediatric medication-focused trigger tool was ineffective in detecting harmful MEs and identifying unsafe situations.
  • A multifaceted method remains the preferred approach for detecting harmful medication errors in pediatric patients.
  • The added value of the evaluated trigger tool for improving medication safety is uncertain.