Development of an emergency department trigger tool

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Shaghayegh Rahmani

Islamic Azad University, Iran

: J Nurs Patient Care

Abstract

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Objective: In this study we developed an Emergency Department Trigger Tool (EDTT) to identify adverse events in the Emergency Department (ED) for improving patient safety and quality improvement. Method: This study was conducted under the supervision of Mashhad University of medical sciences as a four stages project: (1) a systematic review, (2) refining and automating of empiric triggers, (3) a modified Delphi process to identify a list of validated triggers by experts and (4) a final environmental data gathering to identify the best triggers. Results: In this study, a systematic review of electronic resources was performed. There were no previous Persian equivalents about trigger tool. According to the keywords, 502 articles were found in PubMed, 100 articles in Google Scholar and 410 articles in Scopus database. Duplicated articles were removed. Based on the search for article references and similar ones, four articles were added to this number. A total of 1016 article titles were initially reviewed. Articles evaluations were performed by two independent researchers in two different locations on the same date and then the results were compared. In case of disagreement between them, the opinion of the third researcher was used. At this stage, 295 articles were selected. Interpreter reliability was high (0.82). 42 articles were included in the study for final analysis. The designed tool has 50 triggers in six groups. In the review of 100 cases in the emergency department, the number of triggers discovered was 1.2 one per patient file and 99 (79.8%) of these triggers, occurred because of medical errors. Conclusion: In this study, we designed an Emergency Department Trigger Tool (EDTT) using a systematic review and Delphi method. The trigger tool obtained from this study can be used to assess high-risk situations and possible cases of emergency medical errors. One of the most important advantages of this tool compared to previous versions is considering high-risk conditions and not performing the correct action as a trigger and danger indicators. Keywords: Emergency department, Trigger tool, Patient safety, Medical error.

Biography

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Shaghayegh Rahmani has received her master in medicine during 2001- 2008, and her specialty in Emergency Medicine during 2015-2019 at Mashhad University. Currently, she is working as assistant Professor in Mashhad Islamic Azad University of Medical Sciences. She is the Executive Director of the Islamic Azad university journal; she is also the director of research and development center of University. Her research included a wide spectrum from patient safety to clinical and pathological researches.