Journal article
The impact of a nurse led rapid response system on adverse, major adverse events and activation of the medical emergencyteam
Intensive and Critical Care Nursing, Vol.31(2), pp.83-90
2015
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Source: InCites
Abstract
<p><h3 id="x-x-x-sect0010">Aim</h3> <p id="x-x-x-spar0005">To identify the relationship between one example of a <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/rapid-response-team" title="Learn more about Rapid Response Team from ScienceDirect's AI-generated Topic Pages">rapid response system</a> (RRS), specifically, an after-hours Clinical Team Co-Ordinator (CTC), and the incidence of Medical Emergency Team (MET) activations and, adverse and major adverse events in medical patients. <h3 id="x-x-x-sect0015">Method</h3> <p id="x-x-x-spar0010">A retrospective chart <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/clinical-audit" title="Learn more about Clinical Audit from ScienceDirect's AI-generated Topic Pages">audit</a> of patients’ medical records was undertaken. The intervention group consisted of 150 randomly selected medical patients admitted during three months after the introduction of the CTC after-hours service. The control group consisted of 150 randomly selected medical patients admitted before the introduction of the after-hours CTC service. <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/multivariate-logistic-regression-analysis" title="Learn more about Multivariate Logistic Regression Analysis from ScienceDirect's AI-generated Topic Pages">Multiple logistic regression</a> was used to determine which of the potential predictors, along with the after-hours CTC service, were associated with adverse and major adverse events. <h3 id="x-x-x-sect0020">Results</h3> <p id="x-x-x-spar0015">A total of 130 patients (<em>n</em> = 63, 42% control; <em>n</em> = 67, 45% intervention) exhibited physiological abnormalities that should have activated the MET yet it was only activated five times. In total there were 69 adverse events (<em>n</em> = 32, 21% control; <em>n</em> = 36, 25% intervention) and 25 major adverse events (<em>n</em> = 7, 5% control; <em>n</em> = 18, 12% intervention). There were more adverse and major adverse events identified after the introduction of the CTC after-hours service. Changes in heart rate and reduction in Glasgow Coma Scores (GCS) were significant predictors of an adverse event. A low <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/urine-volume" title="Learn more about Urine Volume from ScienceDirect's AI-generated Topic Pages">urine output</a> and a drop of two or more in the GCS were significant predictors of a major adverse event. <h3 id="x-x-x-sect0025">Conclusions</h3> <p id="x-x-x-spar0020">The introduction of an after-hours CTC service in a specific clinical site was associated with an increase in the identification of adverse and major adverse events in medical patients. Further exploration of nurse-led rapid response systems should be undertaken in different clinical settings.</p>
Details
- Title
- The impact of a nurse led rapid response system on adverse, major adverse events and activation of the medical emergencyteam
- Creators
- Deb Massey - Griffith UniversityLeanne M Aitken - Griffith UniversityWendy Chaboyer - Griffith University
- Publication Details
- Intensive and Critical Care Nursing, Vol.31(2), pp.83-90
- Identifiers
- 4028; 991012821934502368
- Academic Unit
- Nursing; Faculty of Health; School of Health and Human Sciences
- Resource Type
- Journal article