TOPLINE

A new German trigger tool identified adverse events (AEs) in pediatric cardiology admissions, with most events causing temporary harm. The tool demonstrated good interrater reliability and was feasible for systematic detection of patient harm in hospitalized children.

METHODOLOGY

• Researchers conducted a retrospective methodological study to develop and evaluate whether the German Pediatric Trigger Tool (PAED‑TT‑GER) could feasibly detect AEs, be used in routine practice, and yield reliable reviewer agreement.
• They reviewed 200 electronic inpatient records from a German pediatric cardiology ward (August 2020-October 2023) of patients younger than 18 years (median age, 4 years; 48.5% girls) who had hospital stays of at least 24 hours and were discharged at least 30 days before review.
• Researchers developed and evaluated PAED-TT-GER through a multistep process including literature review, expert consensus with healthcare professionals, and pilot testing.
• A trained pediatric physician screened records and trigger‑positive cases underwent secondary physician review. Interrater reliability was assessed beforehand on a 27‑record subsample by two trained reviewers.

TAKEAWAY

• The tool identified 472 triggers across patient records, with a mean of 2.36 triggers per admission. The most frequent triggers were hematomas and vascular access complications, circulatory abnormalities, and respiratory abnormalities.
• A total of 45 AEs were confirmed in 42 patients, corresponding to a 21% AE prevalence. Of them, 15.6% were rated as probably to certainly preventable.
• Among identified AEs, 53.3% caused temporary harm requiring intervention, 42.2% caused temporary harm requiring prolonged hospitalization, and 4.4% resulted in permanent harm.
• Researchers reported interrater reliability as an intraclass correlation coefficient of 0.794 for the count of triggers per case (P < .001). On average, 60.4% of all reported triggers were the same for both reviewers.

IN PRACTICE

"By combining established [trigger tool] methodology with context-specific adaptation, it contributes an important instrument for advancing patient safety measurement in pediatric care and provides a solid foundation for future patient safety research," the authors of the study wrote.

SOURCE

The study was led by Anthea Peters, Bonn University, Bonn, Germany. It was published online on August 17 in the European Journal of Pediatrics.

LIMITATIONS

The study was conducted at a single academic hospital, which may have limited generalizability. The retrospective design and reliance on clinical documentation may have missed some adverse events. The study did not assess the sensitivity or specificity of the tool against an external criterion.

DISCLOSURES

The study received funding from kinderherzen Stiftung Bonn. The authors did not declare any competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.