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Table 3 The final trigger tool

From: Adverse events in psychiatry: a national cohort study in Sweden with a unique psychiatric trigger tool

Treatment

 V1

Absence of a care plan

 V2

Absence of an intervention plan

 V3

Lack of suicide risk assessment

 V4

Lack of review of crime relapse risks

 V5

Falls

 V6

Documentation of failure

 V7

Consultation with a physician on call/doctor from another specialty

 V8

Change in diagnosis

 V9

Self-harm

 V10

Undesired effect of treatment other than medication

 V11

Threats, violence and inappropriate behaviour

 V12

Increased surveillance

 V13

Lack of documented physical observations

 V14

Absence of family contact

 V15

Others

Drugs

 Y1

Absence of the alcohol use disorder identification test (AUDIT)

 Y2

Absence of the addiction severity index (ASI)

 Y3

Absence of the expiratory alcohol test

 Y4

Absence of a urinary lab test when addiction is suspected

Coercive treatment

 T1

Coercion treatment–administrative failure

 T2

Coercion

 T3

Conversion from voluntary treatment to coercion (emergency law)

 T4

Police assistance

Medicine

 B1

Use of three or more different antipsychotic drugs

 B2

Treatment with anticholinergics

 B3

Use of more than five different psychotropic drugs

 B4

More than three benzodiazepines or treatment for more than 6 months

 B5

Faults in screening for metabolic risk factors during antipsychotic treatment

 B6

Lack of regular tests for medication with lithium, methylphenidate, methadone/buprenorphine or clozapine

 B7

Medication, others

Continuity and transition

 R1

Unplanned contact with a psychiatric acute unit

 R2

Reinstatement within 30 days

 R3

Change in treatment unit

 R4

Unplanned discharge

 R5

Lack of doctors’ visit during the last 12 months in outpatient care

 R6

Lack of an accountable primary physician