Ranking | ||||||||
---|---|---|---|---|---|---|---|---|
RPN | Relevance | |||||||
Indicator No | Indicator topic | Indicator | Source | Rank | Mean | Highest score | Lowest score | Mean |
Directly included indicators based on the RPN selection criteria | ||||||||
1 | Biochemical/biophysical data | NSAIDs AND (creatinine clearance <60 ml/min OR twofold increase in serum creatinine during the past 2 days OR serum creatinine >1.5 × ULN) | Literature | 1 | 74.0 | 125 | 16 | 4.5 |
2 | Institutional structure | Use of a visual analogue scale OR; numeric rating scale OR; behavioural pain scale | Literature | 2 | 69.3 | 125 | 30 | 4.3 |
3 | Pharmaco-/epidemiology | High dose paracetamol (>4 g/day) AND/OR; one paracetamol–codeine combination drug | Literature | 3 | 68.1 | 125 | 15 | 4.5 |
4 | Pharmaco-/epidemiology | Age >65 AND NSAIDs AND predisposing factors (dehydration, liver cirrhosis, heart disease, renal insufficiency) | CIRS; expert interviews | 4 | 52.3 | 125 | 17 | 4.6 |
5 | Biochemical/biophysical data | NSAIDs AND (elevated risk of bleeding (prolongation of bleeding time) OR; haemoglobin decrease OR; haematocrit decrease ≥25%) | CIRS; expert interviews | 5 | 51.9 | 100 | 17 | 4.3 |
6 | Processes | NSAIDs AND no dose adjustment AND (liver insufficiency OR renal insufficiency) | CIRS; expert interviews | 6 | 51.6 | 100 | 28 | 4.4 |
7 | Clinical event | NSAIDs AND (ulcer OR gastritis OR gastrointestinal bleeding OR gastrointestinal perforation) | Literature | 7 | 50.8 | 80 | 27 | 4.3 |
8 | Pharmaco-/epidemiology | Naloxone AND opioids AND transfer to a higher level of care | CIRS; expert interviews | 8 | 48.6 | 80 | 24 | 4.6 |
9 | Infrastructure | Clinical decision support system AND/OR computerised provider order entry | Literature | 15 | 42.0 | 100 | 9 | 4.4 |
10 | Institutional structure | Electronic medical record system | Literature | 16 | 40.8 | 100 | 9 | 4.3 |
11 | Institutional structure | Opioids AND guidelines for opioid dosing (eg, for opioid rotation) | CIRS; expert interviews | 17 | 38.0 | 64 | 10 | 4.3 |
12 | Pharmaco-/epidemiology | NSAIDS AND oral steroids AND risk factors for gastrointestinal bleeding | Literature | 26 | 34.0 | 75 | 12 | 4.0 |
13 | Institutional structure | Guidelines for the treatment of older patients/seniors (eg, Beer's criteria in place) | Literature | 32 | 31.8 | 45 | 27 | 4.0 |
14 | Institutional structure | Medication reconciliation | Literature | 27 | 33.6 | 60 | 6 | 4.0 |
15 | Institutional structure | Incident reporting error systems AND/OR direct observation AND/OR audit | Literature | 19 | 37.0 | 100 | 6 | 4.0 |
CIRS, critical incident reporting systems; NSAIDS, non-steroidal anti-inflammatory drugs; RPN, risk priority number; ULN, upper limit of normal.