OBJECTIVES: The aim of this study was to improve medication safety for children; it is important to quantify the occurrence of preventable medication errors (MEs). A trigger tool may be an effective and time-saving strategy, but its measurement performance is unclear. Therefore, we aimed to estimate the performance of a pediatric medication-focused trigger tool in detecting harmful MEs.METHODS: First, we established a multifaceted method as a reference comparison. Second, we compared the pediatric medication-focused trigger tool with the multifaceted method in a new cohort of patients. All patients admitted in February and March 2013 were screened using the trigger tool and the multifaceted method to obtain full verification. Data collection was performed in separate teams to guarantee blinding of the test results.RESULTS: Review of the clinical records and the voluntary incident reports was most effective in detecting harmful MEs, so this approach was chosen as a reference comparison. In the second part of the study, 369 patients were included. The multifaceted method identified 33 harmful MEs. In contrast, the trigger tool did not identify any harm. When the 2 symptoms pain and nausea/vomiting were added to the trigger tool, 19 harmful MEs were identified. This extended trigger tool resulted in a sensitivity of 21.2 and a positive predictive value of 36.8.CONCLUSIONS: The original pediatric medication-focused trigger tool yielded only false-positive scores and left unsafe situations undiscovered. We conclude that a multifaceted method remains the preferred method to detect harmful MEs. The additional value of the trigger tool stays unclear.
Although stressors are frequently linked to several negative health outcomes, experiencing stressors may be necessary for enhancing performance. At present, the literature is lacking a unified, comprehensive framework that accounts for both positive and negative outcomes following stressors. Therefore, we introduce the framework of hormesis, which has been applied in biological research for decades. According to hormesis, small-to-medium doses of a stressor can stimulate an organism's response, while large doses cause detrimental effects. In this article, we argue that these dose-response dynamics can be found in various domains of performance psychology (i.e., eustress and distress, psychological momentum, emotions, motivation, confidence, cognitive performance, training, skill acquisition, adversity, and trauma). Furthermore, hormesis also accounts for the inter- and intra-individual variability commonly found in responses to stressors. Finally, from an applied perspective, leveraging hormesis may stimulate new psychological interventions that mimic the well-known effects of (toxic) vaccinations at the level of behavior.
In this document, we provide the methodological background for the Safety atWork project. This document combines several project deliverables as defined inthe overall project plan: validation techniques and methods (D5.1.1), performanceindicators for safety at work (D5.1.2), personal protection equipment methods(D2.1.2), situational awareness methods (D3.1.2), and persuasive technology methods(D4.1.2).
MULTIFILE
