Adverse events identified by the global trigger tool at a university hospital: A retrospective medical record review.

Research paper by Qiaozhi Q Hu, Bin B Wu, Mei M Zhan, Weiguo W Jia, Yimei Y Huang, Ting T Xu

Indexed on: 05 Dec '18Published on: 05 Dec '18Published in: Journal of Evidence-Based Medicine


The purpose of this study was to describe the level, preventability and categories of adverse events (AEs) in Chinese geriatric patients identified by medical record review using the Global Trigger Tool. The applicability of the GTT was also assessed to explore possible modifications for trigger tools. The study was conducted at a 4300-bed tertiary teaching hospital. Twenty randomly-selected medical records for patients over 60 were reviewed every 2 weeks from January 1 2015 to December 31st, 2015. We studied 480 medical records in total. Two trained specialists reviewed the presence of AEs using 43 triggers, and a physician reviewed and validated the findings. The outcome measures included the number of AEs per 1000 patient days, AEs per 100 admissions, the percentage of entries with at least 1 AE and AE categorisation. Also, we carried out a descriptive analysis of the suspected factors of AEs, such as age, gender, length of stay, surgery. A total of 610 AEs were detected in the 480 medical records reviewed, corresponding to 127 injuries per 100 admissions. The number of AEs per 1000 patient days was 22.43. AEs occurred at least once in 329 (68.54%) patients. The rate of care harms ranked highest of all AEs, followed by the rate of medication harms and surgical harms. Patients with a more extended hospital stay or surgery was more likely to experience AEs. However, there was a negative correlation between age and the rate of AEs. The Global Trigger Tool was a useful method for detecting the characteristics of AEs in geriatric patients in a Chinese tertiary teaching hospital. To improve patients' safety, this tool should be incorporated into routine screening systems. © 2018 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.