APPENDIX 6: FLORIDA SUB-CATEGORIES DEFINITIONS
Florida Hospital
Adverse Event/Harm
Categories & SubCategories
Trigger Description
Operational Definition
Events Related to
Medication/Intravenous
Fluids
Clostridium difficile
medication associated
infection
C-difficile positive stool
Anti-diarrhoeal
IV volume
overload/electrolyte
imbalance
As per GTT trigger definition (HQSC GTT
guide)
Check Fluid balance charts & laboratory
results to see if harm has occurred. Harm is
defined if patient experiences symptoms
associated with overload such as shortness
of breath. Check if patient requires diuresis,
increase in diuretic dose or fluid is stopped.
Kidney damage due to
contrast dye
Raised Urea / Creatinine
Medication related
cardiac event/arrhythmia
Abrupt medication stop
As per GTT/ADE trigger definition (HQSC
GTT guide)
Medication related renal
insufficiency
Raised Urea / Creatinine
As per GTT trigger definition (HQSC GTT
guide)
Medication related
allergic reaction
Medication related
bleeding
(> 2 x baseline)
(> 2 x baseline)
Antihistamines) / IV
Corticosteroid
Partial thromboplastin time
> 100 secs
As per GTT trigger definition (HQSC GTT
guide)
As per GTT trigger definition (HQSC GTT
guide)
As per GTT trigger definition (HQSC GTT
guide)
INR > 4
Other
Medication related
delirium, confusion, or
over-sedation
Naloxone use
As per GTT trigger definition (HQSC GTT
guide)
Over-sedation/Hypotension
Review the physician progress notes,
nursing or multidisciplinary notes for
evidence of over –sedation, confusion,
delirium and lethargy. Review vital signs
records or graphics for episodes of
hypotension related to the administration of
a sedative analgesic or muscle relaxant.
Medication related
Anti-diarrhoeal
Look for diarrhoea associated with
diarrhoea
antibiotics/ other medications or C. difficile
infection caused by antibiotics.
Medication related
glycemic events
Hypoglycaemia (< 3
mmol/L)
Medication related
hypotension
Over-sedation/ Hypotension
Abrupt medication stop
Medication related
nausea and vomiting
Anti-emetics
Medication related
constipation
Laxatives
As per GTT trigger definition (HQSC GTT
guide)
As per GTT trigger definition (HQSC GTT
guide)
As per GTT trigger definition (HQSC GTT
guide)
Constipation can be due to medications
such as opiates or regularly used
antiemetics such as Ondansetron. If
laxatives have been prescribed, review
notes and bowel chart (if present) to see
whether constipation has occurred and
whether this is secondary to medication.
Bowels not opened for > 3 days is
defined as constipation.
Other
Events Related to
Patient Care
DVT/VTE
Radiological investigation
for PE/DVT
As per GTT trigger definition (HQSC GTT
guide)
Any operative complication
This refers to any number of complications,
including but not limited to PE, DVT,
decubiti, MI renal failure etc.
Fall with injury
Patient fall
A fall in a care setting represents a failure
of care and may be the result of
medications, equipment failure or failure of
adequate staffing. A fall with no injury – no
harm. A fall with injury is an AE. A fall which
requires treatment due to injury – category
F. Falls resulting in higher care (eg cerebral
bleed) – Category G/H or above. A
mechanical fall in the community is not a
harm.
Skin tear, abrasion, or
other breakdown
Any procedure/treatment
complication
Other than pressure ulcers, any form of
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
Pressure Ulcer/injury
Pressure injury presenting as full thickness
ulcer
tissue loss with or without visible bone,
tendon or muscle exposure
Other
Hospital Acquired
Infection
Catheter associated
urinary tract infection
Healthcare associated
infection /
As per GTT trigger definition (HQSC GTT
guide)
Positive blood culture
Central line associated
blood stream infection
Healthcare associated
infection /
As per GTT trigger definition (HQSC GTT
guide)
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 /
As per GTT trigger definition (HQSC GTT
guide)
Positive blood culture
As per GTT trigger definition (HQSC GTT
guide)
Positive blood culture
As per GTT trigger definition (HQSC GTT
guide)
Positive blood culture
Ventilator associated
pneumonia
Healthcare associated
infection /
As per GTT trigger definition (HQSC GTT
guide)
Pneumonia onset
Other
Events Related to
Surgery or Other
Procedure
Abnormal bleeding
following surgery or
procedure
Decrease of greater than
25% in Hb or Hct
As per GTT trigger definition (HQSC GTT
guide)
Blood clots and other
occlusions related to
surgery or procedure
Decrease of greater than
25% in Hb or Hct
Cardiac complications
related to surgery or
procedure
Post-op troponin level
greater than 1.5 ng/ml
Complications related to
peripheral venous or
arterial puncture
Any operative complication
As per GTT trigger definition (HQSC GTT
guide)
Hypotension/blood loss
Transfusion/use of blood
As per GTT trigger definition (HQSC GTT
guide)
Transfusion/use of blood
As per GTT trigger definition (HQSC GTT
guide)
Radiological investigation
for PE/DVT
As per GTT trigger definition (HQSC GTT
guide)
Any operative complication
Decrease of greater than
25% in Hb or Hct
Post-op acute renal
failure
Acute dialysis
Raised Urea / Creatinine
As per GTT trigger definition (HQSC GTT
guide)
(> 2 x baseline)
Any operative complication
Post-op spinal tap/
lumbar puncture /epidural
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
As per GTT trigger definition (HQSC GTT
guide)
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
As per GTT trigger definition (HQSC GTT
guide)
Any operative complication
Removal retained foreign
body
Return to theatre
X-ray intra-op or in PACU
As per GTT trigger definition (HQSC GTT
guide)
Removal, injury or repair
of organ
Injury, repair or removal of
organ
As per GTT trigger definition (HQSC GTT
guide)
Respiratory complications
related to surgery or
procedure
Intubation/reintubation/BiPap in PACU
As per GTT trigger definition (HQSC GTT
guide)
Mechanical ventilation > 24
hours post-op
Other
Events Related to
Intensive Care
Catheter associated
urinary tract infection
Healthcare associated
infection
As per GTT trigger definition (HQSC GTT
guide)
Positive blood culture
Central line associated
blood stream infection
Healthcare associated
infection
As per GTT trigger definition (HQSC GTT
guide)
Positive blood culture
Peripheral or central line
non-blood stream
infection
Healthcare associated
infection
Respiratory infection
(non-ventilator
associated)
Healthcare associated
infection
As per GTT trigger definition (HQSC GTT
guide)
Positive blood culture
Positive blood culture
As per GTT trigger definition (HQSC GTT
guide)
Surgical Infection
Healthcare associated
infection
As per GTT trigger definition (HQSC GTT
guide)
Positive blood culture
Ventilator associated
pneumonia
Healthcare associated
infection
Pneumonia onset
Other
As per GTT trigger definition (HQSC GTT
guide)