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Detection of Adverse Events in an Acute Geriatric Hospital over a 6‐Year Period Using the Global Trigger Tool
Author(s) -
Suarez Cristina,
Menendez María Dolores,
Alonso Josefina,
Castaño Nieves,
Alonso Marta,
Vazquez Fernando
Publication year - 2014
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12774
Subject(s) - medicine , adverse effect , confidence interval , medical record , emergency medicine , retrospective cohort study , pediatrics
Objectives To assess the frequency, severity, and preventability of adverse events ( AE s) detected using the Global Trigger Tool ( GTT ) in an acute geriatric hospital. Design A 6‐year retrospective study. Setting An urban Spanish acute geriatric teaching hospital of 200 beds. Participants Ten randomly selected clinical records were chosen every fortnight from January 2007 to December 2012 (1,440 records, 240 per year). Measurements Triggers, AE s, Index of the National Coordinating Council for Medication Error Reporting and Prevention ( NCC MERP ) categories of severity, and Likert scale to evaluate the preventability of AE s. Results Four hundred twenty‐four AE s (categories E to I of the NCC MERP Index) were identified in 335 of the 1,440 individuals scrutinized, which corresponded to 29.4 physical injuries per 100 admissions (95% confidence interval ( CI ) = 25.7–34.7). Of these, 351 (91.7%) occurred 3 or more days after admission; 279 harms (65.8%) were preventable. Significant decreases in the rate of harms per 1,000 patient‐days (21.8 vs 27.1, relative risk ( RR ) = 0.77, 95% CI 0.66–0.91, P = .02) and in high‐severity events (categories F to I) (11/720 clinical records in 2011–2012 vs 23/720 clinical records in 2007–2009) ( RR = 0.48, 95% CI = 0.24–0.96, P = .04) were observed during the second half of the study from the first. The number needed to alert was 7.8. Conclusion The frequency and severity of AE s decreased during the period of study. Factors possibly contributing to the decrease in AE s include new beds with variable height, pressure ulcer prevention, introduction of clinical electronic records, staff training on hand washing, surgical check list, correct patient identification, and Agency for Healthcare Research and Quality surveys on patient safety culture.