Enhancing Adverse Event Detection: The Modified Cataract Surgical Trigger Tool in Cataract Surgery Patients

Introduction: The inherent risk of patient safety incidents during cataract surgery is accentuated by the swift nature of the procedure, high surgical volume, and rapid turnover. Conventional hospital efforts relying on voluntary incident reporting systems have demonstrated ineffectiveness. This study proposes the use of a modified Cataract Surgical Trigger Tool, specifically designed to identify perioperative adverse events in cataract surgery. The tool aims to facilitate the easy and sustainable detection of unexpected incidents, addressing the challenges posed by the high-paced environment of cataract surgery.

Methods: Retrospective Observational Study on adult patients undergoing cataract surgery as inpatients during 2020- 2023. This study focuses on the identification of administrative triggers, clinical triggers, and adverse events (AE) in adult patients. Triggers were systematically identified, and a harm category was assigned. This category includes the grade indicating the potential avoidability of the AE and its correlation with the surgical procedure. Technical analysis used in this research was descriptive statistic

Results: This retrospective review analyzed 160 medical records of hospitalized adults undergoing cataract surgery from January 2020 to December 2023. Findings indicate a yearly decrease in administrative and clinical harm triggers. Specific areas such as patient handovers, doctor documentation, informed consent completeness, and patient reassessment exhibited significant declines (p < 0.05). Surgical complications also decreased significantly (p < 0.05), and no instances of wrong side surgery, wrong procedure, or wrong IOL were observed from 2020 to 2023. Adverse events per 1000 hospital days and per 100 inpatient cataract patients demonstrated a consistent yearly decrease

Conclusion: The Modified Cataract Surgery Trigger Tool presents a practical and user-friendly approach for detecting safety issues in surgical patients. It serves as a valuable tool not only for estimating the frequency of adverse events in a hospital but also for assessing the impact of interventions aimed at reducing such events in surgical patients.

 

Keywords: Adverse Events, cataract surgery, Trigger tool