Estonian adverse events study for multimorbid patients using Estonian Trigger Tool (MUPETT-MUltimorbid Patients-Estonian Trigger Tool). Development of Estonian trigger tool for multimorbid patients. A study protocol for mixed-methods study

Angela Kannukene; Carola Orrego; Margus Lember; Anneli Uusküla; Kaja Põlluste

doi:10.1371/journal.pone.0280200

Estonian adverse events study for multimorbid patients using Estonian Trigger Tool (MUPETT-MUltimorbid Patients-Estonian Trigger Tool). Development of Estonian trigger tool for multimorbid patients. A study protocol for mixed-methods study

PLoS One. 2023 Mar 16;18(3):e0280200. doi: 10.1371/journal.pone.0280200. eCollection 2023.

Authors

Angela Kannukene¹, Carola Orrego², Margus Lember^{1

3}, Anneli Uusküla^{4

5}, Kaja Põlluste¹

Affiliations

¹ Department of Medicine, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
² Avedis Donabedian Research Institute (FAD), Universitat Autònoma de Barcelona, Barcelona, Spain.
³ Clinic of Internal Medicine, Tartu University Hospital, Tartu, Estonia.
⁴ Department of Medicine, Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
⁵ Clinic of Dermatology, Tartu Univeristy Hospital, Tartu, Estonia.

Abstract

Introduction: It is widely recognized that providing healthcare may produce harm to the patient. Different approaches have been developed to measure the burden of adverse events (AEs) to plan and measure the effects of interventions. One of the most widely used instruments is the Trigger Tool, which has previously been modified to be used on various settings and translated into many languages. Multimorbidity complicates care and may increase the number of AEs patients experience. Currently there is no instrument designed to measure AEs in multimorbid patients. In Estonia, there is currently no validated instrument to measure the burden of AEs.

Aims: The aim of this study will be evaluating the characteristics and ocurrence of AEs in multimorbid patients in hospitalised internal medicine patients of Estonia, and describes the development of a trigger tool for this purpose.

Methods and analysis: We will search for the evidence on measuring AEs in the population of multimorbid patients focusing on trigger tools, and synthesize the data. Data collection of the triggers from the literature will be followed by translating triggers from English to Estonian. An expert multidisciplinary panel will select the suitable triggers for this population. Trigger tool will be pre-tested to assess agreement among professionals and usability of the tool. Validation will be done using 90 medical records. A cross-sectional study in internal medicine departments of two Estonian tertiary care hospitals will be performed to identify the frequency and characteristics of AEs in 960 medical records. We will also provide preventability potential and influencing factors.

Dissemination: Results will be disseminated to healthcare providers and stakeholders at national and international conferences, and as a doctoral medical thesis.

Copyright: © 2023 Kannukene et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Estonia / epidemiology
Humans
Medical Errors*
Multimorbidity*
Patient Safety
Retrospective Studies

Grants and funding

AK, CO, KP, ML - This paper is part of the PATSAFE project, funded by the European Union's Horizon 2020, Coordination and Support Action programme, under grant agreement No 857359 The funders had and will not have a role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.