New Zealand Trigger Tool Adverse Event Subcategories
Adverse Event SubCategories
Triggers possibly
associated to identified
harm
Operational Definition
Clostridium difficile
medication associated
infection
C-difficile positive stool
A positive C-difficile assay identified and
associated to recent antibiotics
IV volume
overload/electrolyte
imbalance
Anti-diarrhoeal
Other
Fluid overload identified with associated
symptoms such as shortness of breath
Diuretic prescribed or IV fluid stopped
Kidney damage due to
contrast dye
Raised Urea / Creatinine
Medication related
cardiac event/arrhythmia
Abrupt medication stop
Bradycardia, tachycardia or other events
due to cardiac medications identified
Medication related renal
insufficiency
Raised Urea / Creatinine
(> 2 x baseline)
Acute kidney injury resulting in twice the
patient baseline creatinine contributed by
identified medications, for example,
gentamicin
Medication related
allergic reaction
Antihistamines) / IV
Corticosteroid
Identified allergic reaction due to known or
unknown drug allergy
Medication related
bleeding
Partial thromboplastin time
> 100 secs
Bleeds identified secondary to antiplatelet
or anticoagulant therapy
(> 2 x baseline)
Acute kidney injury resulting in twice the
patient baseline creatinine secondary to
recently administered contrast
INR > 4
Other
Over –sedation, confusion and/or delirium
related to medications
Medication related
delirium, confusion, or
over-sedation
Naloxone use
Medication related
diarrhoea
Anti-diarrhoeal
Diarrhoea associated with antibiotics or
other medications identified
Medication related
glycemic events
Hypoglycaemia (< 3
mmol/L)
Hypoglycaemia with associated symptoms
due to insulin or oral hypoglycaemic agents
Medication related
hypotension
Over-sedation/ Hypotension
Hypotension identified with associated
symptoms secondary to medications such
as antihypertensive agents
Over-sedation/Hypotension
Abrupt medication stop
Medication related
nausea and vomiting
Anti-emetics
Ongoing (3 or more episodes within 24
hours) nausea or vomiting identified due to
medications
DVT/VTE
Radiological investigation
for PE/DVT
Deep vein thrombosis or pulmonary emboli
identified during stay in hospital
Any operative complication
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Fall with injury
Patient fall
A fall with injury as a result of medications,
equipment failure or failure of adequate
staffing or care
Skin tear, abrasion, or
other breakdown
Any procedure/treatment
complication
Identified trauma to the skin from a medical
intervention, for example, skin tear
secondary to removal of plasters such as
Tegaderm.
Other
Stage I or II pressure
ulcer
Pressure Ulcer/injury
Pressure injury presenting as intact skin
with redness over a localised area or partial
thickness loss of dermis without slough.
Stage III or IV pressure
ulcer
Pressure Ulcer/injury
Pressure injury presenting as full thickness
tissue loss with or without visible bone,
tendon or muscle exposure
Catheter associated
urinary tract infection
Healthcare associated
infection
Urinary tract infection identified due to the
presence of a catheter
Positive blood culture
Central line associated
blood stream infection
Healthcare associated
infection
Central line associated septicaemia
identified
Positive blood culture
Peripheral or central line
non-blood stream
infection
Healthcare associated
infection
Respiratory infection
(non-ventilator
associated)
Healthcare associated
infection
Surgical infection
Healthcare associated
infection
Line Infection secondary to insertion of
peripheral or central lines
Positive blood culture
Hospital acquired pneumonia or respiratory
tract infection
Positive blood culture
Identified surgical site infections
Positive blood culture
Ventilator associated
pneumonia
Healthcare associated
infection
Respiratory infections associated to
mechanical ventilation
Pneumonia onset
Abnormal bleeding
following surgery or
procedure
Decrease of greater than
25% in Hb or Hct
Transfusion/use of blood
Excessive bleeding following surgery that
required blood transfusion or return to
theatres/ monitoring
Blood clots and other
occlusions related to
surgery or procedure
Decrease of greater than
25% in Hb or Hct
Haematomas, pulmonary emboli or deep
vein thrombosis identified following surgery
Cardiac complications
related to surgery or
procedure
Post-op troponin level
greater than 1.5 ng/ml
Radiological investigation
for PE/DVT
Any operative complication
Any cardiac complications, for example,
myocardial infarct, identified during surgery
or postoperatively
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Complications related to
peripheral venous or
arterial puncture
Any operative complication
Complications such as pseudo-aneurysm or
sepsis identified as a result of arterial or
venous cannulation
Hypotension/blood loss
Transfusion/use of blood
Hypotension with associated symptoms due
to blood loss in surgery
Decrease of greater than
25% in Hb or Hct
Post-op acute renal
failure
Acute dialysis
Raised Urea / Creatinine
(> 2 x baseline)
Acute kidney injury occurred as a result of
surgery resulting in creatinine to be more
than twice patient baseline
Any operative complication
Post-op spinal tap
headache
Any operative complication
Headache associated with any procedure
which can occur 1 – 5 days after
Premature extubation
causing respiratory failure
Intubation/reintubation/BiPap in PACU
Respiratory depression as a result of early
removal of tube
Mechanical ventilation > 24
hours post-op
Prolonged post-op ileus
Any operative complication
Diagnosis of ileus with nil bowel movement
for 3 days or more for non-abdominal
surgery and 4 days or more for abdominal
surgery, with associated symptoms.
Radiation related injury
Any procedure/treatment
complication
Any injury or associated symptoms due to
radiation poisoning
Any operative complication
Removal retained foreign
body
Return to theatre
X-ray intra-op or in PACU
Surgical mishap identified as a result of
retained foreign object after surgery
Removal, injury or repair
of organ
Injury, repair or removal of
organ
Unintended removal, injury or repair of
organ identified
Respiratory complications
related to surgery or
procedure
Intubation/reintubation/BiPap in PACU
A complication postoperatively or due to
any procedure that resulted in respiratory
depression
Other
Other
Mechanical ventilation > 24
hours post-op
Any adverse event as a result of medical
intervention that cannot be placed in any
other subcategory
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