Mitigating risk in psychiatric hospital care for older adults by identifying adverse events with Global Trigger Tool for psychiatric patients

Background Older adults receiving psychiatric care are at greater risk of adverse events (AEs) than younger patients. This reflects broader vulnerabilities, including marginalization, complex health needs, and frequent transitions between care settings. It is therefore necessary to investigate AE risk in this population and to validate a previous version of the Global Trigger Tool – Psychiatry (GTT-P), originally developed for the general psychiatric population, for use with older psychiatric patients. Objective To apply the Norwegian version of GTT-P in psychiatric care for older adults, to identify the prevalence of AEs in this subpopulation. Methods A retrospective cohort study was conducted by reviewing medical records of 184 patients aged 65+ admitted to a psychiatric hospital between 2022 and 2023. All patients who did not opt out were included. Results AEs were identified in 10.9% of patients. Triggers related to compulsory treatment and medication significantly increased AE risk. No AEs occurred without associated triggers. Of the AEs identified, 63% were considered avoidable. Conclusions This study demonstrates the utility of GTT-P in detecting AEs in older psychiatric patients. Specific clinical triggers were significantly associated with AEs. Preventive strategies and improved care coordination are essential to reduce avoidable harm and enhance patient safety in psychiatric care.