Forty-seven screening criteria of the preliminary Canadian Association of Paediatric Health Centres Trigger Tool (CPTT)* and positive predictive values for each trigger
| Care module | Positive predictive value | |
| C01 | Transfusion/use of blood products | 42.7 |
| C02 | Any code or arrest | 62.5 |
| C03‡ | Unplanned admission (including readmission) as a result of any healthcare management within the 3 months prior to or after discharge from the index hospitalisation | 26.3 |
| C04 | Infection of any kind | 54.1 |
| C05 | In-hospital stroke | 33.3 |
| C06 | Transfer to higher level of care | 45.8 |
| C07 | Catheter infiltration/burn | 35.3 |
| C08§ | Wrong maternal breast milk | ns† |
| C09 | Complication related to central venous catheter | 61.1 |
| C10 | Necrotising enterocolitis | 66.7 |
| C11 | Cranial imaging in infants <3 months | 38.8 |
| C12 | Extreme temperature: ≤35.0°C or ≥41°C | 35.5 |
| C13 | Intubation/reintubation/accidental extubation | 51.5 |
| C14 | Unexpected death | 80.0 |
| C15 | Emergent C-section delivery (neonate only) | 40.0 |
| C16‡ | Unplanned admission (including readmission) as a result of any healthcare management within the 12 months prior to the index admission | 23.8 |
| C17§ | Unplanned transfer to another acute care hospital (excluding transfers for tests, procedures or specialised care not available at referring hospital) | ns† |
| C18§ | Inappropriate discharge to home/inadequate discharge plan for Index Hospitalisation (excluding ‘against medical advice’) | 20.0 |
| C19 | Dissatisfaction with care documented in the medical record and/or evidence of complaint lodged (including documented complaint, conflict between patient/family and staff, discharged against medical advice/documentation or correspondence indicating litigation, either contemplated or actual | 30.0 |
| ICU module | ||
| I01 | Readmission to ICU | 33.3 |
| I02 | In-unit procedure | 66.7 |
| I03 | Failed intubation | 83.3 |
| Laboratory module | ||
| L01 | Abrupt drop >25% Hgb or Hct | 48.8 |
| L02§ | Leucopenia | 18.8 |
| Age <1 month WBC <5000/mm e3 (5.0×10 e9/l) | ||
| Age 1–23 months WBC <4000/mm e3 (4.0×10 e9/l) | ||
| Age 2–18 years WBC <3000/mm e3 (3.0×10 e9/l) | ||
| L03 | Platelet count < 50 000/mm e3 (50.0×10 e9/l) | 55.6 |
| L04 | PTT>100 s or INR >6 | 66.7 |
| L05 | d-dimer (positive by local lab normal) | 62.5 |
| L06§ | Glucose <2.8 mmol/l (50 mg/dl) | 25.0 |
| L07 | Sodium: 120 mmol/l >Na >150 mmol/l | 46.2 |
| L08 | Potassium: 3.0 mmol/l >K+ >6.0 mmol/l | 35.6 |
| L09 | Rising BUN/creat >2×baseline | 68.5 |
| L10 | Hypoxia: O2 Sat <75% | 48.1 |
| L11 | Positive blood culture | 64.3 |
| L12 | Gentamicin: (except CF patients); trough >2 mg/l or peak >10 mg/l | 44.0 |
| Medication module | ||
| M01 | Vitamin K (excluding newborns) | 28.6 |
| M02§ | Benadryl (diphenhydramine): for symptoms of allergic reaction | 18.2 |
| M03§ | Narcan (naloxone) | 0.0 |
| M04§ | Antiemetic use (for treatment of symptoms) | 20.0 |
| M05§ | Sodium or calcium polystyrene (kayexalate, resonium) | ns† |
| M06 | Heparin or low-molecular-weight heparin | 52.4 |
| Surgical module | ||
| S01 | Unplanned or return to surgery | 77.8 |
| S02 | Intraoperative intravenous epinephrine, norepinephrine, naloxone, flumazenil | 63.6 |
| S03§ | Pathology report normal/unrelated | 15.0 |
| S04§ | Insertion of arterial or central venous line during surgery (excluding CV surgery) | 25.0 |
| S05 | Removal/injury or repair of organ | 40.0 |
| S06¶ | Wrong site/wrong procedure/wrong patient | NS† |
| Other module | ||
| O01 | Any other undesirable outcome not covered above | 31.4 |
All other triggers were retained in the final 35-trigger CPTT.
↵* The positive predictive value and ultimate disposition of each trigger are also shown.
↵† Screening criterion (trigger) was never selected by nurse reviewers in this sample of 600 cases.
↵‡ Screening criterion C16 merged with C03.
↵§ Screening criterion (trigger) with low positive predictive value or not selected removed from CPTT.
↵¶ Wrong site/wrong procedure/wrong patient criterion: a rare event but always associated with an AE and therefore retained despite NS designation.
ICU, intensive care unit; Hgb, haemoglobin; Hct, haematocrit; WBC, While blood count; PTT, partial thromboplastin time; INR, international normalised ratio; BUN, blood urea nitrogen; creat, creatinine; CF, cystic fibrosis; CV, cardiovascular.