A trigger tool to detect harm in pediatric inpatient settings.

Area of Science:

• Pediatric Patient Safety
• Healthcare Quality Improvement
• Medical Error Analysis

Background:

• Measuring harm in pediatric care is crucial for patient safety.
• Existing trigger tools, like the adult Global Trigger Tool, need adaptation for pediatric populations.
• Pediatric inpatient environments present unique challenges for harm identification.

Purpose of the Study:

• To develop and pilot test a novel pediatric trigger tool for identifying common causes of harm in hospitalized children.
• To adapt the adult Global Trigger Tool methodology for pediatric patient safety.

Main Methods:

• Six academic children's hospitals participated in the pilot study.
• A novel pediatric trigger tool was used to review 100 randomly selected inpatient records per site.
• Trained reviewers analyzed patient charts discharged in February 2012.

Main Results:

• A total of 600 patient records were reviewed, identifying 240 harmful events.
• The rate of harm was 40 per 100 patients and 54.9 per 1000 patient days.
• Intravenous catheter infiltrations, respiratory distress, and pain were common harms; 45% were potentially preventable.

Conclusions:

• Harm occurs frequently in hospitalized children, similar to adult rates.
• The developed pediatric trigger tool provides a consistent method for assessing harm.
• This tool is essential for establishing the epidemiology of harm and evaluating safety interventions.