Table 1 Description of triggers and categories in the trigger tool. For full instrument see Patterson et al. (28)
From: Patient safety and patient assessment in pre-hospital care: a study protocol
Triggers (11) |
|---|
Documentation triggers |
1. Missing, incomplete, or unclear documentation for the following: chief complaint, physical assessment, vital signs, haemodynamic monitoring, allergies, pertinent history or medications, patient condition at handoff. |
Operational & patient movement triggers |
2. Time from initial patient contact to transfer of care exceeds accepted standards. |
3. Injury to patient or team member during patient encounter/transport. |
4. Request for additional resources, personnel, or supervisor due to change in patient condition. |
Patient condition triggers |
5. A worsening trend in patient haemodynamic or mental status indicators. |
6. Cardiac arrest during transport. |
Intervention & medication triggers |
7. Use of any of the following interventions during patient care: cardioversion, defibrillation, transcutaneous pacing, advanced airway attempt, surgical airway, intraosseous (IO), chest decompression, chest tube. |
8. Failure of any intervention or procedure during patient care. |
9. Use of following medications or fluids: blood products, vasopressors, inotrope, naloxone. |
10. Evidence of deviation from standard of care by performing an intervention or administering a medication that appears to be outside protocol or failure to perform an intervention or provide a medication that is within the standard of care. |
11. Medication error. |
Categories (5) |
1. Actions By Patient: The adverse event was the result of action(s) by the patient. |
2. Actions By Provider: The adverse event was the result of action(s) or inaction(s) by the crew. |
3. Medical or Vehicle Equipment: Failure of the equipment, failure to troubleshoot and correct common problems with the equipment, or failure to remove defective equipment from service. |
4. Environmental/Scene Factors: Factors that may result from weather conditions or factors on the ground/scene (or other). This includes temperature, light and scene safety. |
5. Undetermined by Chart Review: The proximal cause of the adverse events (regardless of severity) cannot be determined by the information available in the chart. |
Classification (3) |
1. No adverse events |
2. Adverse event present – potential for harm |
3. Adverse event – harm identified |