Identifying no-harm incidents in home healthcare: a cohort study using trigger tool methodology.

Marléne Lindblad; Maria Unbeck; Lena Nilsson; Kristina Schildmeijer; Mirjam Ekstedt

Study

Identifying no-harm incidents in home healthcare: a cohort study using trigger tool methodology.

August 5, 2020

Lindblad M, Unbeck M, Nilsson L, et al. BMC Health Serv Res. 2020;20(1):289.

View more articles from the same authors.

This study used a trigger tool to retrospectively identify and characterize no-harm incidents affecting adult patients in home healthcare settings in Sweden. The most common incidents identified by the trigger tool were falls without injury, medication management incidents, and moderate pain. Common contributing factors included delayed, erroneous, or incomplete nursing care and treatment.

PubMed citation

Free full text

Related Resources From the Same Author(s)

Exploring nursing-sensitive events in home healthcare: a national multicenter cohort study using a trigger tool.

January 25, 2023

Occurrence of no-harm incidents and adverse events in hospitalized patients with ischemic stroke or TIA: a cohort study using trigger tool methodology.

April 20, 2022

Adverse events in patients in home healthcare: a retrospective record review using trigger tool methodology.

February 21, 2018

Development of a trigger tool to identify adverse events and no-harm incidents that affect patients admitted to home healthcare.

October 18, 2017

Adaptive design: adaptation and adoption of patient safety practices in daily routines, a multi-site study.

August 12, 2020

Exploring psychological safety in healthcare teams to inform the development of interventions: combining observational, survey and interview data.

October 28, 2020

How does the WHO Surgical Safety Checklist fit with existing perioperative risk management strategies? An ethnographic study across surgical specialties.

March 18, 2020

Closing the loop on test results to reduce communication failures: a rapid review of evidence, practice and patient perspectives.

November 25, 2020

A systematic review exploring the content and outcomes of interventions to improve psychological safety, speaking up and voice behaviour.

March 18, 2020

Strengthening open disclosure after incidents in maternity care: a realist synthesis of international research evidence.

April 12, 2023

A qualitative study of what care workers do to provide patient safety at home through telecare.

June 23, 2021

Seniors managing multiple medications: using mixed methods to view the home care safety lens.

March 2, 2016

Negative emotions experienced by healthcare staff following medication administration errors: a descriptive study using text-mining and content analysis of incident data.

December 21, 2022

Evaluation of older persons' medications: a critical incident technique study exploring healthcare professionals' experiences and actions.

June 23, 2021

The development of the concept of return-on-investment from large-scale quality improvement programmes in healthcare: an integrative systematic literature review.

January 11, 2023

March 11, 2020

Support opportunities for second victims lessons learned: a qualitative study of the top 20 US News and World Report Honor Roll Hospitals.

January 19, 2022

Health care workers' experiences of workplace incidents that posed a risk of patient and worker injury: a critical incident technique analysis.

July 14, 2021

Adverse events in women giving birth in a labor ward: a retrospective record review study.

November 3, 2021

The impact of hospital accreditation on the quality of healthcare: a systematic literature review.

October 27, 2021

The role of feedback in emergency ambulance services: a qualitative interview study.

April 6, 2022

Patients and relatives as auditors of safe practices in oncology and hematology day hospitals.

March 31, 2021

Exploring the barriers and facilitators of psychological safety in primary care teams: a qualitative study.

May 19, 2021

Differences in medication reconciliation interventions between six hospitals: a mixed method study.

June 29, 2022

Organizational readiness to change as a leverage point for improving safety: a national nursing home survey.

September 8, 2021

Experience of learning from everyday work in daily safety huddles: a multi-method study.

September 14, 2022

Is detection of adverse events affected by record review methodology? An evaluation of the "Harvard Medical Practice Study" method and the "Global Trigger Tool."

May 8, 2013

Psychosocial working conditions as determinants of concerns to have made important medical errors and possible intermediate factors of this association among medical assistants - a cohort study.

March 8, 2023

Associations of person-related, environment-related and communication-related factors on medication errors in public and private hospitals: a retrospective clinical audit.

November 17, 2021

COVID-19 pandemic preparation: using simulation for systems-based learning to prepare the largest healthcare workforce and system in Canada.

September 30, 2020

Fidelity and the impact of patient safety huddles on teamwork and safety culture: an evaluation of the Huddle Up for Safer Healthcare (HUSH) project.

October 20, 2021

Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (The IMMENSE study) - a randomized controlled trial.

November 30, 2022

Predictive power of the "trigger tool" for the detection of adverse events in general surgery: a multicenter observational validation study.

March 9, 2022

Internet of things in healthcare for patient safety: an empirical study.

March 16, 2022

The presence and potential impact of psychological safety in the healthcare setting: an evidence synthesis.

August 25, 2021

A human factors intervention in a hospital--evaluating the outcome of a TeamSTEPPS program in a surgical ward.

April 14, 2021

What is needed to sustain improvements in hospital practices post-COVID-19? A qualitative study of interprofessional dissonance in hospital infection prevention and control.

May 4, 2022

Improving medication appropriateness in nursing homes via structured interprofessional medication-review supported by health information technology: a non-randomized controlled study.

February 24, 2021

Organizational conditions for engagement in quality and safety improvement: a longitudinal qualitative study of community pharmacies.

February 6, 2019

Patient safety culture as a space of social struggle: understanding infection prevention practice and patient safety culture within hospital isolation settings - a qualitative study.

December 14, 2022

How gender shapes interprofessional teamwork in the operating room: a qualitative secondary analysis.

January 26, 2022

Shared understanding of resilient practices in the context of inpatient suicide prevention: a narrative synthesis.

August 17, 2022

Medication dosage calculation among nursing students: does digital technology make a difference? A literature review.

September 14, 2022

Diagnostic errors reported in primary healthcare and emergency departments: a retrospective and descriptive cohort study of 4830 reported cases of preventable harm in Sweden.

October 9, 2019

Reduction in omission events after implementing a rapid response system: a mortality review in a department of gastrointestinal surgery.

March 15, 2023

Interdisciplinary clinicians' attitudes, challenges, and success strategies in providing care to transgender people: a qualitative descriptive study.

October 19, 2022

Measurement matters: changing penalty calculations under the hospital acquired condition reduction program (HACRP) cost hospitals millions.

February 24, 2021

Prescribers' perspectives on including reason for use information on prescriptions and medication labels: a qualitative thematic analysis.

March 10, 2021

Patient safety measurement tools used in nursing homes: a systematic literature review.

December 7, 2022

Psychological safety during the test of new work processes in an emergency department.

April 6, 2022

Effect of burnout among physicians on observed adverse patient outcomes: a literature review.

June 16, 2021

Artificial intelligence for identifying the prevention of medication incidents causing serious or moderate harm: an analysis using incident reporters' views.

November 24, 2021

"Time is of the essence": relationship between hospital staff perceptions of time, safety attitudes and staff wellbeing.

December 8, 2021

Combined impact of Medicare's hospital pay for performance programs on quality and safety outcomes is mixed.

August 10, 2022

Comparison of a voluntary safety reporting system to a global trigger tool for identifying adverse events in an oncology population.

August 3, 2022

Clinician-identified problems and solutions for delayed diagnosis in primary care: a PRIORITIZE study.

October 5, 2016

Why do hospital prescribers continue antibiotics when it is safe to stop? Results of a choice experiment survey.

September 2, 2020

Variation in detected adverse events using trigger tools: a systematic review and meta-analysis.

September 21, 2022

Using the Global Trigger Tool in surgical and neurosurgical patients: a feasibility study.

September 7, 2022

Nurses' workarounds in acute healthcare settings: a scoping review.

June 19, 2013

Transformational improvement in quality care and health systems: the next decade.

November 25, 2020

Learning from incident reporting? Analysis of incidents resulting in patient injuries in a web-based system in Swedish health care.

December 9, 2020

Characteristics of morbidity and mortality conferences associated with the implementation of patient safety improvement initiatives, an observational study.

March 16, 2016

Patient safety when receiving telephone advice in primary care - a Swedish qualitative interview study.

February 23, 2022

Learning from diagnostic errors to improve patient safety when GPs work in or alongside emergency departments: incorporating realist methodology into patient safety incident report analysis.

January 12, 2022

Higher incidence of adverse events in isolated patients compared with non-isolated patients: a cohort study.

November 18, 2020

Acting between guidelines and reality- an interview study exploring the strategies of first line managers in patient safety work.

February 3, 2021

Patient safety in chiropractic teaching programs: a mixed methods study.

December 23, 2020

The safety of health care for ethnic minority patients: a systematic review.

July 29, 2020

Preventable medication harm across health care settings: a systematic review and meta-analysis.

February 17, 2021

Stroke hospitalization after misdiagnosis of "benign dizziness" is lower in specialty care than general practice: a population-based cohort analysis of missed stroke using SPADE methods.

July 21, 2021

Detection of missed fractures of hand and forearm in whole-body CT in a blinded reassessment.

September 29, 2021

The effect of structured medication review followed by face-to-face feedback to prescribers on adverse drug events recognition and prevention in older inpatients - a multicenter interrupted time series study.

August 10, 2022

Strengths and weaknesses of working with the Global Trigger Tool method for retrospective record review: focus group interviews with team members.

October 9, 2013

Patient involvement for improved patient safety: a qualitative study of nurses' perceptions and experiences.

November 22, 2017

The accuracy of the Global Trigger Tool is higher for the identification of adverse events of greater harm: a diagnostic test study.

March 22, 2023

Suicide as an incident of severe patient harm: a retrospective cohort study of investigations after suicide in Swedish healthcare in a 13-year perspective.

March 31, 2021

The influence of professional identity on how the receiver receives and responds to a speaking up message: a cross-sectional study.

March 29, 2023

The physiology of failure: identifying risk factors for mortality in emergency general surgery patients using a regional health system integrated electronic medical record.

September 7, 2022

Rate of sepsis hospitalizations after misdiagnosis in adult emergency department patients: a look-forward analysis with administrative claims data using Symptom-Disease Pair Analysis of Diagnostic Error methodology in an integrated health system.

May 12, 2021

Seroprevalence of SARS-CoV-2 among frontline health care personnel in a multistate hospital network--13 academic medical centers, April-June 2020.

September 23, 2020

Perceptions of providing safe care for frail older people at home: a qualitative study based on focus group interviews with home care staff.

November 10, 2021

Incidence and characteristics of adverse events in paediatric inpatient care: a systematic review and meta-analysis.

January 25, 2023

Assessment of adverse events in medical care: lack of consistency between experienced teams using the Global Trigger Tool.

March 14, 2012

Prospective validation of classification of intraoperative adverse events (ClassIntra): international, multicentre cohort study.

October 7, 2020

Telemedicine as a medical examination tool during the Covid-19 emergency: the experience of the onco-haematology center of Tor Vergata Hospital in Rome.

December 23, 2020

Acute care nurses' perceptions of leadership, teamwork, turnover intention and patient safety - a mixed methods study.

October 13, 2021

Understanding nurses' and physicians' fear of repercussions for reporting errors: clinician characteristics, organization demographics, or leadership factors?

September 16, 2015

Development of rapid response capabilities in a large COVID-19 alternate care site using Failure Modes and Effect Analysis with in situ simulation.

November 18, 2020

Causes of adverse events in home mechanical ventilation: a nursing perspective.

October 12, 2022

The accuracy of preliminary diagnoses made by paramedics - a cross-sectional comparative study.

October 7, 2020

Enhancing teamwork communication and patient safety responsiveness in a paediatric intensive care unit using the daily safety huddle tool.

March 18, 2020

The effectiveness of improving healthcare teams' human factor skills using simulation-based training: a systematic review.

August 3, 2022

April 27, 2022

The psychometric properties of the 'Hospital Survey on Patient Safety Culture' in Dutch hospitals.

January 21, 2009

The critical role of health information technology in the safe integration of behavioral health and primary care to improve patient care.

November 10, 2021

Performance of a trigger tool for detecting drug-related hospital admissions in older people: analysis from the OPERAM trial.

February 16, 2022

Adverse events associated with home blood transfusion: a retrospective cohort study.

May 12, 2021

Provider bias in prescribing opioid analgesics: a study of electronic medical records at a hospital emergency department.

September 8, 2021

Post-discharge adverse events among African American and Caucasian patients of an urban community hospital.

July 15, 2020

Related Resources

An mHealth design to promote medication safety in children with medical complexity.

March 20, 2024

Clinical deterioration as a nurse sensitive indicator in the out-of-hospital context: a scoping review.

January 24, 2024

Using stakeholder intervention refinement teams to develop approaches for real-time integration of patient-reported safety information during older adults’ hospital-to-home-health care transitions.

November 15, 2023

Home Health Agencies Failed To Report Over Half of Falls With Major Injury and Hospitalization Among Their Medicare Patients.

November 8, 2023

Flow of information contributing to medication incidents in home care- an analysis considering incident reporters' perspectives.

October 25, 2023

Widespread misinterpretation of advance directives and Portable Orders for Life-Sustaining Treatments threatens patient safety and causes undertreatment and overtreatment.

July 12, 2023

The challenge of risk prevention in home healthcare-an interview study with nurses in municipal care.

July 12, 2023

Patient safety and sense of security when telemonitoring chronic conditions at home: the views of patients and healthcare professionals - a qualitative study.

July 5, 2023

The impact of safety culture, quality of care, missed care and nurse staffing on patient falls: a multisource association study.

June 28, 2023

Approaches to improving patient safety in integrated care: a scoping review.

June 14, 2023

Home health agency patient experience measures and their relationship to Joint Commission accreditation.

June 7, 2023

Patient safety in home health care: a grounded theory study.

May 24, 2023

Teamwork, clinical leadership skills and environmental factors that influence missed nursing care - a qualitative study on hospital wards.

May 3, 2023

Annual Perspective

Improving Diagnostic Safety and Quality

April 26, 2023

Registered nurses' efforts to ensure safety for home-dwelling older patients.

February 22, 2023

Exploring nursing-sensitive events in home healthcare: a national multicenter cohort study using a trigger tool.

January 25, 2023

Self-reported gaps in care coordination and preventable adverse outcomes among older adults receiving home health care.

January 18, 2023

Prevent administration of ear drops into the eyes.

December 14, 2022

Causes of adverse events in home mechanical ventilation: a nursing perspective.

October 12, 2022

Exploring care left undone in pediatric nursing.

September 28, 2022

High-risk medication in home care nursing: a Delphi study.

September 7, 2022

Families’ experiences of central-line infection in children: a qualitative study.

September 7, 2022

Developing and aligning a safety event taxonomy for inpatient psychiatry.

July 13, 2022

Analysis of readmissions in a mobile integrated health transitional care program using root cause analysis and common cause analysis.

May 25, 2022

Patient safety in home care: a multicenter cross-sectional study about medication errors and medication management of nurses.

May 18, 2022

Observational evidence of the prevalence and association of polypharmacy and drug administration errors in hospitalized adult patients.

May 18, 2022

Medication errors' causes analysis in home care setting: a systematic review.

February 9, 2022

Staffing, teamwork and scope of practice: analysis of the association with patient safety in the context of rehabilitation.

December 15, 2021

Perceptions of providing safe care for frail older people at home: a qualitative study based on focus group interviews with home care staff.

November 10, 2021

The work of nurses to provide good and safe services to children receiving hospital-at-home: a qualitative interview study from the perspectives of hospital nurses and physicians.

October 20, 2021

See More About The Topic

Home Care

Quality and Safety Professionals

Home Nursing

Administration Errors

Patient Falls

Identifying no-harm incidents in home healthcare: a cohort study using trigger tool methodology.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Identifying no-harm incidents in home healthcare: a cohort study using trigger tool methodology.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site