Effects of a Rapid Reponse Team on Antecedents to Patient Deterioration : A Descriptive Study.

2.50
Hdl Handle:
http://hdl.handle.net/10755/157122
Category:
Abstract
Type:
Presentation
Title:
Effects of a Rapid Reponse Team on Antecedents to Patient Deterioration : A Descriptive Study.
Author(s):
Kelly, Mary Jo
Author Details:
Mary Jo Kelly, University Of Washington Medical Center, Seattle, Washington, USA, email: mj98125@msn.com
Abstract:
PURPOSE: Examine the relationships between clinical triggers and rapid response calls in patients on acute care units, describe the prevalence and most common clinical triggers (missed and detected), and compare the mortality rates pre/post RRT. BACKGROUND: Adverse events in hospitalized patients are responsible for preventable deaths. In-hospital cardiac arrest survival remained stagnant at 17% despite the evolution of code teams. Patients presented with physiological abnormalities (clinical triggers) several hours prior to their clinical deterioration. Mortality rates were higher when patients who did not receive medical intervention prior to their clinical deterioration. Rapid Response Teams (RRT) were developed as an early intervention to improve patient outcomes and reduce mortality rates. RRT provided highly skilled assistance to patients in an acute care setting when they present with signs of physiological deterioration. At a Pacific Northwest Academic Medical Center a RRT was available to respond to a patient's bedside 24 hours a day. This RRT evolved from a single stat nurse into a RRT four years ago. METHODS: A descriptive study utilizing a retrospective chart review was conducted at a 396 bed academic hospital in the Pacific Northwest. A random sampling of 84 patients admitted to acute care units who have experienced a negative outcome from January 01, 2007 to December 31, 2007 were studied. Mean age=60.8 years old, 40 females and 44males, 65% of sample were Caucasian. Four data bases were queried: death records, transfer to higher level of care, Code 199 records, and RRT Catalyst Tool. An existing rapid response data collection tool was utilized. The data was presented and analyzed using descriptive statistics, measures of frequency of distribution, central tendency, and relationships. RESULTS: The most common triggers for activating the RRT at this institution were acute mental status change, O2 Saturation <90%,RR>28 or <8 breaths/minute, and SBP <90mm Hg or 20% decrease from baseline. Assistance was summoned 87% of the time, resulting in a rate of 13% missed triggers. Patients presented with a mean of 2.5 triggers(SD +/- 1.4)when the Stat RN was the mode of activation and a mean of 3.1 triggers(SD +/- .96) when the RRT was the mode of activation. From onset of clinical trigger to disposition of patient when the Stat RN was called was 127 minutes (SD +/- 166 minutes)and 107 minutes(SD +/- 74 minutes)when the RRT was activated, which was not significantly different. NS change was found in mortality. CONCLUSIONS: Education may increase recognition of clinical triggers and this may reduce the 13% of missed triggers. Evaluation of causes for the delay from onset of trigger to disposition of the patient is needed to reduce the risk of harm to patients in acute care units. Investigation is also recommended to evaluate if the tachycardia trigger should be adjusted to HR >20% above baseline to allow for earlier recognition of patient deterioration. Implementing the stat nurse program likely reduced mortality.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleEffects of a Rapid Reponse Team on Antecedents to Patient Deterioration : A Descriptive Study.en_GB
dc.contributor.authorKelly, Mary Joen_GB
dc.author.detailsMary Jo Kelly, University Of Washington Medical Center, Seattle, Washington, USA, email: mj98125@msn.comen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157122-
dc.description.abstractPURPOSE: Examine the relationships between clinical triggers and rapid response calls in patients on acute care units, describe the prevalence and most common clinical triggers (missed and detected), and compare the mortality rates pre/post RRT. BACKGROUND: Adverse events in hospitalized patients are responsible for preventable deaths. In-hospital cardiac arrest survival remained stagnant at 17% despite the evolution of code teams. Patients presented with physiological abnormalities (clinical triggers) several hours prior to their clinical deterioration. Mortality rates were higher when patients who did not receive medical intervention prior to their clinical deterioration. Rapid Response Teams (RRT) were developed as an early intervention to improve patient outcomes and reduce mortality rates. RRT provided highly skilled assistance to patients in an acute care setting when they present with signs of physiological deterioration. At a Pacific Northwest Academic Medical Center a RRT was available to respond to a patient's bedside 24 hours a day. This RRT evolved from a single stat nurse into a RRT four years ago. METHODS: A descriptive study utilizing a retrospective chart review was conducted at a 396 bed academic hospital in the Pacific Northwest. A random sampling of 84 patients admitted to acute care units who have experienced a negative outcome from January 01, 2007 to December 31, 2007 were studied. Mean age=60.8 years old, 40 females and 44males, 65% of sample were Caucasian. Four data bases were queried: death records, transfer to higher level of care, Code 199 records, and RRT Catalyst Tool. An existing rapid response data collection tool was utilized. The data was presented and analyzed using descriptive statistics, measures of frequency of distribution, central tendency, and relationships. RESULTS: The most common triggers for activating the RRT at this institution were acute mental status change, O2 Saturation <90%,RR>28 or <8 breaths/minute, and SBP <90mm Hg or 20% decrease from baseline. Assistance was summoned 87% of the time, resulting in a rate of 13% missed triggers. Patients presented with a mean of 2.5 triggers(SD +/- 1.4)when the Stat RN was the mode of activation and a mean of 3.1 triggers(SD +/- .96) when the RRT was the mode of activation. From onset of clinical trigger to disposition of patient when the Stat RN was called was 127 minutes (SD +/- 166 minutes)and 107 minutes(SD +/- 74 minutes)when the RRT was activated, which was not significantly different. NS change was found in mortality. CONCLUSIONS: Education may increase recognition of clinical triggers and this may reduce the 13% of missed triggers. Evaluation of causes for the delay from onset of trigger to disposition of the patient is needed to reduce the risk of harm to patients in acute care units. Investigation is also recommended to evaluate if the tachycardia trigger should be adjusted to HR >20% above baseline to allow for earlier recognition of patient deterioration. Implementing the stat nurse program likely reduced mortality.en_GB
dc.date.available2011-10-26T19:26:27Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:26:27Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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