Adverse drug events (ADEs) are a common cause of morbidity and mortality in the nursing home setting. Despite their frequency and potential impact, current methods of ADE detection leads to a significant number of undetected events. Trigger Tools have been developed by the Institute for Healthcare Improvement to prioritize a list of triggers that can be used to detect adverse drug events in a variety of care settings, including the hospital and ambulatory care.

The Trigger Tool for Measuring Adverse Drug Events in the Nursing Home includes a list of triggers that can be used by clinicians to detect ADEs specifically for use in the nursing home setting.

The list of triggers was developed based on a comprehensive review of the literature, followed by a two-round, modified Delphi survey of expert physicians, pharmacists, and advanced practitioners. The consensus list of triggers includes: 15 laboratory/medication combinations, 12 medication concentrations, 10 antidotes, and 3 Resident Assessment Protocols (derived from the Minimum Data Set).

The complete methodology and results associated with the list of triggers has been published in:

Handler SM, et al. Consensus list of signals to detect potential adverse drug reactions in nursing homes. Journal of the American Geriatric Society. 2008 May;56(5):808-815.

Download the tool for complete instructions.

Refer to the IHI Trigger Tool for Measuring ADEs for specific directions for the Trigger Tool methodology.