A mixed methods study to effectively utilize trigger tools in the ICU.

Autor: Lip A; Department of Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address: alip@qmed.ca., Stelfox HT; Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada; Alberta Health Services-Calgary Zone, Calgary, Alberta, Canada., Au S; Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada.
Jazyk: angličtina
Zdroj: Journal of critical care [J Crit Care] 2021 Feb; Vol. 61, pp. 57-62. Date of Electronic Publication: 2020 Oct 04.
DOI: 10.1016/j.jcrc.2020.09.033
Abstrakt: Purpose: This study aimed to create a trigger tool for our intensive care units (ICUs) to support our departmental quality improvement efforts.
Methods: We compiled an initial list of triggers used in an ICU setting through literature review. We used a modified Delphi method to develop a unique set of triggers. An expert panel was selected for multidisciplinary and multi-site representation from four adult medical-surgical ICUs of a Canadian city. Respondents ranked triggers on a Likert scale based on its likelihood of being associated with adverse event (sensitivity to harm), and likelihood of being associated with suboptimal ICU processes (specificity for internal recommendations).
Outcomes: Our literature search yielded 10 articles and 59 triggers. Completion of the rating process resulted in 12 items that achieved consensus. Triggers included specific clinical, hospital-acquired infection, medication related, and procedural occurrences. One additional trigger (cardiopulmonary arrest) which consistently held high scores but did not achieve multidisciplinary consensus, was also included.
Conclusions: We used the modified Delphi process to derive consensus-selected triggers to identify ICU specific adverse events with opportunity for improvement in local care. This methodology can be adopted by other centers looking to introduce trigger tools in a manner selective to their practice needs.
Competing Interests: Declaration of Competing Interest On behalf of all authors, the corresponding author states that there is no conflict of interest.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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