Table 4 Palestinian version of the Institute for Healthcare Improvement Global Trigger Tool (IHI-GTT) for measuring adverse events
From: The relationship between patient safety culture and adverse events: a study in palestinian hospitals
Care module triggers | + | Event description and harm category (E-I) | Medication module triggers | + | Event description and harm category (E-I) | ||
|---|---|---|---|---|---|---|---|
C1 | Transfusion or use of blood products | M1 | Clostridium difficile positive stool | ||||
C2 | Code/arrest/rapid response team | M2 | Partial thromboplastin time greater than 100 s | ||||
C3 | Acute dialysis | M3 | International Normalized Ratio (INR) greater than 6 | ||||
C4 | Positive blood culture | M4 | Glucose less than 50 mg/dl | ||||
C5 | X-ray or Doppler studies for emboli or deep vein thrombosis (DVT) | M5 | Rising blood urea nitrogen (BUN) or serum creatinine greater than 2 times baseline | ||||
C6 | Decrease of greater than 25% in hemoglobin or hematocrit | M6 | Vitamin K administration | ||||
C7 | Patient fall | M7 | Benadryl (Diphenhydramine) use | ||||
C8 | Pressure ulcers | M8 | Romazicon (Flumazenil), Anexate, Mazicon use | ||||
C9 | Readmission within 30 days | M9 | Naloxone (Narcan) Nalone, Narcanti use | ||||
C10 | Restraint use | M10 | Antiemetic use | ||||
C11 | Health care-associated infection | M11 | Over-sedation/hypotension | ||||
C12 | In-hospital stroke | M12 | Abrupt stop of medication | ||||
C13 | Transfer to higher level of care | M13 | Skin rash | ||||
C14 | Any procedure complication | M14 | Other | ||||
C15 | Other | ||||||
Surgical Module Triggers | Intensive Care Module Triggers | ||||||
S1 | Return to surgery | I1 | Pneumonia onset | ||||
S2 | Change in anesthetic or procedure during surgery | I2 | Readmission to intensive care | ||||
S3 | Admission to intensive care post-op | I3 | In-unit procedure | ||||
S4 | Intubation/reintubation/BiPap in Postanesthesia Care Unit (PACU) | I4 | Intubation/reintubation | ||||
S5 | X-ray intra-op or in PACU | ||||||
S6 | Intra-op or post-op death | Prenatal module triggers | |||||
S7 | Mechanical ventilation greater than 24 h post-op | P1 | Terbutaline use | ||||
S8 | Intra-op epinephrine, norepinephrine, naloxone, or romazicon | P2 | 3rd- or 4th-degree lacerations | ||||
S9 | Post-op troponin level greater than 1.5 ng/ml | P3 | Platelet count less than 50,000 | ||||
S10 | Injury, repair, or removal of organ | P4 | Estimated blood loss > 500 ml (vaginal) or > 1,000 ml (C-section) | ||||
S11 | Any operative complication | P5 | Specialty consult | ||||
S12 | Consult request post-anesthesia | P6 | Oxytocic agents | ||||
P7 | Instrumented delivery | ||||||
P8 | General anesthesia | ||||||
P9 | Maternal/neonatal transport/transfer | ||||||
Emergency department (ED) module triggers | |||||||
E1 | Readmission to ED within 48 h | ||||||
E2 | Time in ED greater than 6 h | ||||||