TY - JOUR
T1 - Introducing the Safety Threats and Adverse events in Trauma (STAT) taxonomy
T2 - standardized classification system for evaluating safety during trauma resuscitation
AU - Baletic, Nemanja
AU - Riggs, Jamie
AU - Lebovic, Gerald
AU - Petrosoniak, Andrew
AU - Dumas, Ryan P.
AU - Nolan, Brodie
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
PY - 2022/12
Y1 - 2022/12
N2 - Purpose: Adverse events (AEs) during trauma resuscitation are common and heterogeneity in reporting limits comparisons between hospitals and systems. A recent modified Delphi study established a taxonomy of AEs that occur during trauma resuscitation. This tool was further refined to yield the Safety Threats and Adverse events in Trauma (STAT) taxonomy. The objective of this study was to evaluate the inter-rater reliability of the STAT taxonomy using in-situ simulation resuscitations. Methods: Two reviewers utilized the STAT taxonomy to score 12 in-situ simulated trauma resuscitations. AEs were reported for each simulation and timestamped in the case of multiple occurrences of a single AE. Inter-rater reliability was assessed using Gwet’s AC1. Results: The agreement on all AEs between reviewers was 90.1% (973/1080). The Gwet’s AC1 across AE categories were: EMS handover (median 0.72, IQR [0.54, 0.82]), airway and breathing (median 0.91, IQR [0.60, 1.0]), circulation (median 0.91, IQR [0.72, 1.0]), assessment of injuries (median 0.80, IQR [0.24, 0.91]), management of injuries (median 1.00, IQR [1.00, 1.00]), procedure related (median 1.00, IQR [81, 1.00]), patient monitoring and IV access (median 1.00, IQR [1.00, 1.00]), disposition (median 1.00, IQR [1.00, 1.00]), team communication and dynamics (median 0.80, IQR [0.62, 1.00]). Conclusions: The STAT taxonomy yielded 90.1% agreement and demonstrated excellent inter-rater reliability between reviewers in the in-situ simulation scenario. The STAT taxonomy may serve as a standardized evaluation tool of latent safety threats and adverse events in the trauma bay. Future work should focus on applying this tool to live trauma patients.
AB - Purpose: Adverse events (AEs) during trauma resuscitation are common and heterogeneity in reporting limits comparisons between hospitals and systems. A recent modified Delphi study established a taxonomy of AEs that occur during trauma resuscitation. This tool was further refined to yield the Safety Threats and Adverse events in Trauma (STAT) taxonomy. The objective of this study was to evaluate the inter-rater reliability of the STAT taxonomy using in-situ simulation resuscitations. Methods: Two reviewers utilized the STAT taxonomy to score 12 in-situ simulated trauma resuscitations. AEs were reported for each simulation and timestamped in the case of multiple occurrences of a single AE. Inter-rater reliability was assessed using Gwet’s AC1. Results: The agreement on all AEs between reviewers was 90.1% (973/1080). The Gwet’s AC1 across AE categories were: EMS handover (median 0.72, IQR [0.54, 0.82]), airway and breathing (median 0.91, IQR [0.60, 1.0]), circulation (median 0.91, IQR [0.72, 1.0]), assessment of injuries (median 0.80, IQR [0.24, 0.91]), management of injuries (median 1.00, IQR [1.00, 1.00]), procedure related (median 1.00, IQR [81, 1.00]), patient monitoring and IV access (median 1.00, IQR [1.00, 1.00]), disposition (median 1.00, IQR [1.00, 1.00]), team communication and dynamics (median 0.80, IQR [0.62, 1.00]). Conclusions: The STAT taxonomy yielded 90.1% agreement and demonstrated excellent inter-rater reliability between reviewers in the in-situ simulation scenario. The STAT taxonomy may serve as a standardized evaluation tool of latent safety threats and adverse events in the trauma bay. Future work should focus on applying this tool to live trauma patients.
KW - Adverse events
KW - Inter-rater reliability
KW - Resuscitation
KW - Trauma
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U2 - 10.1007/s00068-022-02007-9
DO - 10.1007/s00068-022-02007-9
M3 - Article
C2 - 35670817
AN - SCOPUS:85131514859
SN - 1863-9933
VL - 48
SP - 4775
EP - 4781
JO - European Journal of Trauma and Emergency Surgery
JF - European Journal of Trauma and Emergency Surgery
IS - 6
ER -