ReviewBMC health services research2014
Validation of triggers and development of a pediatric trigger tool to identify adverse events.
Review in BMC health services research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Incidence and characteristics of adverse events in paediatric inpatient care: a systematic review and meta-analysis.BMJ quality & safety · 2023Pooled it
- Variation in detected adverse events using trigger tools: A systematic review and meta-analysis.PloS one · 2022Pooled it
- Development and evaluation of a German Paediatric Trigger Tool (PAED-TT-GER) for detecting adverse events in hospitalized children.European journal of pediatrics · 2026Article
- Experiences of the development and use of a Paediatric Oncology Trigger Tool.BMJ open quality · 2025Article
- Development of a trigger tool to identify adverse events and no-harm incidents in paediatric oncology: a modified Delphi process using expert knowledge and user experiences.Frontiers in health services · 2025Article
- Adverse events in the neonatal intensive care unit identified by triggers.Frontiers in pharmacology · 2025Article
- Article
- Adaption of a trigger tool to identify harmful incidents, no harm incidents, and near misses in prehospital emergency care of children.BMC emergency medicine · 2024Article
- Development of a trigger tool to identify harmful incidents, no harm incidents, and near misses in prehospital emergency care.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Article
- Analysis of medication-related triggers to determine adverse drug events.European journal of hospital pharmacy : science and practice · 2023Article
- Article
- Development of an Electronic Trigger to Identify Delayed Follow-up HbA1c Testing for Patients with Uncontrolled Diabetes.Journal of general internal medicine · 2022Article
- Occurrence of No-Harm Incidents and Adverse Events in Hospitalized Patients with Ischemic Stroke or TIA: A Cohort Study Using Trigger Tool Methodology.International journal of environmental research and public health · 2022Article
- Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study.Patient safety in surgery · 2022Article
- Predicting Adverse Drug Events in Chinese Pediatric Inpatients With the Associated Risk Factors: A Machine Learning Study.Frontiers in pharmacology · 2021Article
- Establishment of a pediatric trigger tool based on Global Trigger Tool to identify adverse drug events of children: experience in a Chinese hospital.BMC pediatrics · 2020Article
- Association between cancer-specific adverse event triggers and mortality: A validation study.Cancer medicine · 2020Article
- Adverse events in psychiatry: a national cohort study in Sweden with a unique psychiatric trigger tool.BMC psychiatry · 2020Article
- Developing a cancer-specific trigger tool to identify treatment-related adverse events using administrative data.Cancer medicine · 2020Article
- Translation, Cross-Cultural Adaptation, and Measurement Properties of the Portuguese Version of the Global Trigger Tool for Adverse Events.Therapeutics and clinical risk management · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLittle is known about adverse events (AEs) in pediatric patients. Record review is a common methodology for identifying AEs, but in pediatrics the record review tools generally have limited focus. The aim of the present study was to develop a broadly applicable record review tool to identify AEs in pediatric inpatients.
methodsUsing a broad literature review and expert opinion with a modified Delphi process, a pediatric trigger tool with 88 triggers, definitions, and descriptions including AE preventability decision support was developed and tested in a random sample of 600 hospitalized pediatric patients admitted in 2010 to a single university children's hospital. Four registered nurse-physician teams performed complete two-stage retrospective reviews of 150 records each from either neonatal, surgical/orthopedic, medicine, or emergency medicine units.
resultsRegistered nurse review identified 296 of 600 records with triggers indicating potential AEs. Records (n = 121) with only false positive triggers not indicating any potential AEs were not forwarded to the next review stage. On subsequent physician review, 204 (34.0%) of patients were found to have had 563 AEs, range 1-27 AEs/patient. A total of 442 preventable AEs were found in 161 patients (26.8%), range 1-22. Overall, triggers were found 3,598 times in 417 (69.5%) records, with a mean of 6 (median 1, range 0-176) triggers per patient. The overall positive predictive value of the triggers was 22.9%, (range 0.0-100.0%). The final pediatric trigger tool, developed with a second Delphi round, required 29 triggers.
conclusionsAEs are common in pediatric patients and most are preventable. The main contributions of this study are to further develop and adapt trigger definitions, including AE preventability decision support, to introduce new triggers in pediatric care, as well as to apply pediatric triggers in different clinical specialties. Our findings resulted in a national pediatric trigger tool, and might also be adapted internationally. The pediatric trigger tool can help healthcare organizations to measure and analyze the AEs occurring in hospitalized children in order to improve patient safety.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.