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Table 1 Example of a trigger description

From: Validation of triggers and development of a pediatric trigger tool to identify adverse events

Urinary retention

 

Definition

Urinary retention (age and weight related)

10 ml per kilo (children up to 20 kg) + 20%

100 ml (children ≥ 20 kilo) + (age in years x 20) + 20%

Description of the trigger

Urinary retention is to be assessed as an adverse event if there is more urine in the bladder than listed in the values above. Patients who have urinary retention on admission will be excluded unless it can be considered to derive from earlier treatment within 30 days.

Urinary retention can occur, for example, in connection with pain, opiate treatment, epidural anesthesia, or spinal cord compression.

Inter individual variations concerning the maximum volume of the bladder exist.

Be observant of urine amounts in connection with, for example, surgery and analgesic, and review the monitoring curves per- and postoperatively, and the nursing documentation.

Harm that can be detected

Risk of bladder muscle damage due to over tension can cause the patient pain, discomfort and urinary tract infection. Bladder muscle harm can be permanent if over tension becomes severe or lasts for a long time. For the patient, this can mean lifelong needs of mechanical emptying of the bladder.

Risk of bladder muscle damage due to over tension can cause the patient pain, discomfort, and urinary tract infection. Bladder muscle harm can be permanent if over tension becomes severe or lasts for a long time. For the patient, this can mean lifelong needs of mechanical emptying of the bladder.

Preventability

These adverse events should be assessed as preventable.

Drugs (ATC), diagnosis (ICD-10) or procedure code associated with this trigger

ICD-10-code:

R33.9 (urinary retention)

Measures or products associated with this trigger

Urinary retention for children, age- and weight-related. Detected by, for example, bladder scan.