Parents' Trigger Tool for Children with Medical Complexity - PAT-CMC: Development of a recognition tool for clinical deterioration at home.
Catia Genna, Kiara Ros Thekkan, Caterina Geremia and 9 others
PMID 38661213WHAT IT FOUND
A home recognition tool for medically complex children was built from parent and provider ratings.
It lists 23 warning signs in seven groups. Content was validated, but no evidence yet that using it improves child outcomes.
Key findings
01In Delphi round 2, 30 signs and symptoms were rated important by more than 75% of both parent and healthcare provider panels.
02The final PAT-CMC tool contains seven clusters and 23 items, with vital-sign thresholds left open for personalization.
03The study reports content validation only and does not provide evidence of screening power or criterion validity.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study only validated the content of the tool. It did not test internal validity, external validity, screening power, or criterion validity. No evidence is provided that using PAT-CMC improves recognition of deterioration, reduces hospital admissions, or changes child outcomes. The sample came from one tertiary paediatric hospital in Italy and used convenience and purposive recruitment, so the tool may not transfer to other settings or populations. Parent and healthcare provider consensus was not identical: parents agreed on all 30 items in round 3, while healthcare providers agreed on 21 items, and nine items did not reach consensus. Delphi response numbers were lower than invited, with 20 parents and 19 healthcare providers responding in round 3. Usability and the escalation process were not explored.
Declared interests
The study was funded by the Italian Ministry of Health. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that PAT-CMC has been proven to detect deterioration or reduce hospital admissions. The paper reports development and content validation only, and the authors state that screening power, external validity, and effects on outcomes still need future study.