Upstream Factors (triggers) Influencing Initiation of Rapid Response Team: A Mixed Methods Analysis of Associations

2.50
Hdl Handle:
http://hdl.handle.net/10755/183144
Category:
Abstract
Type:
Presentation
Title:
Upstream Factors (triggers) Influencing Initiation of Rapid Response Team: A Mixed Methods Analysis of Associations
Author(s):
Garcia, Fatima
Author Details:
Fatima Garcia, RN, BSN, Mercy Hospital, Miami, FL, email: fgarcia1@comcast.net
Abstract:
Purpose: In hospital cardio-respiratory arrest is a clinical challenge that results in extended hospital stays and increased morbidity. Such events can be distressing for nurses and other health care providers who may feel unprepared to manage a cardio-respiratory arrest. Most acute care hospitals have critical care nurses and respiratory therapists who are experienced and proficient in managing these crisis situations. When these professionals are called upon early to provide this expertise they can prevent loss of life, reduce hospital costs, and work with other clinicians to avert feelings of inadequacy that may be felt by clinicians who are not experienced in managing such a crisis. The purpose of this study was to assess upstream factors (missed triggers) in patients with in-hospital cardiac arrest occurring in non-critical care areas, identify associations between these factors and health outcomes, as a strategy to guide staff training for initiation and early intervention by the rapid response team (RRT). Method: With IRB approval retrospective medical record (MR) reviews were conducted for all cardiac arrest in non-critical care areas patients (n = 23) during the 4 month data collection period. The MR review instrument was developed using criteria from the Institute for Healthcare Improvement's (IHI) 100k lives campaign launched in 2004. The instrument assessed qualitative and quantitative indicators to identify factors (missed triggers) that may have contributed to decline in clinical condition. Findings: Early qualitative analysis revealed few common indicators for RRT among this sample. Descriptive statistics will be presented including frequencies for primary and secondary diagnoses, health care provider interventions, and trends observed in vital signs and diagnostic test/procedures recorded in the MR. We then used logistic regression to identify associations between clinical indicators and health outcome. Discussion: The IHI recommended RRT as a lifesaving strategy. Perhaps our lack of findings is due to the small sample size. Future studies should include a longer timeframe of analysis or include multiple sites either across corporate structures or within geographic areas. Determining upstream factors (missed triggers) and staff training and support will improve skills in patient assessment and willingness to initiate a call for help from the RRT. The information gained from this study will identify trends and opportunities for improving the care of hospitalized patients at risk for in-hospital cardiac arrest. Additionally, it will reinforce the conceptualization that there truly is a team of experts at each patient's bedside regardless of unit specialization.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2010
Conference Name:
7th Annual Florida Magnet Research Conference
Conference Host:
University of South Florida College of Nursing; Sigma Theta Tau International; Florida Organization of Nurse Executives
Conference Location:
Naples, Florida, USA
Description:
7th Annual Florida Magnet Research Conference - Theme: Research at the Point of Care. Held 11-13 February 2010 at the Naples Grande Beach Resort, Naples, Florida, 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_US
dc.typePresentationen_GB
dc.titleUpstream Factors (triggers) Influencing Initiation of Rapid Response Team: A Mixed Methods Analysis of Associationsen_GB
dc.contributor.authorGarcia, Fatimaen_US
dc.author.detailsFatima Garcia, RN, BSN, Mercy Hospital, Miami, FL, email: fgarcia1@comcast.neten_US
dc.identifier.urihttp://hdl.handle.net/10755/183144-
dc.description.abstractPurpose: In hospital cardio-respiratory arrest is a clinical challenge that results in extended hospital stays and increased morbidity. Such events can be distressing for nurses and other health care providers who may feel unprepared to manage a cardio-respiratory arrest. Most acute care hospitals have critical care nurses and respiratory therapists who are experienced and proficient in managing these crisis situations. When these professionals are called upon early to provide this expertise they can prevent loss of life, reduce hospital costs, and work with other clinicians to avert feelings of inadequacy that may be felt by clinicians who are not experienced in managing such a crisis. The purpose of this study was to assess upstream factors (missed triggers) in patients with in-hospital cardiac arrest occurring in non-critical care areas, identify associations between these factors and health outcomes, as a strategy to guide staff training for initiation and early intervention by the rapid response team (RRT). Method: With IRB approval retrospective medical record (MR) reviews were conducted for all cardiac arrest in non-critical care areas patients (n = 23) during the 4 month data collection period. The MR review instrument was developed using criteria from the Institute for Healthcare Improvement's (IHI) 100k lives campaign launched in 2004. The instrument assessed qualitative and quantitative indicators to identify factors (missed triggers) that may have contributed to decline in clinical condition. Findings: Early qualitative analysis revealed few common indicators for RRT among this sample. Descriptive statistics will be presented including frequencies for primary and secondary diagnoses, health care provider interventions, and trends observed in vital signs and diagnostic test/procedures recorded in the MR. We then used logistic regression to identify associations between clinical indicators and health outcome. Discussion: The IHI recommended RRT as a lifesaving strategy. Perhaps our lack of findings is due to the small sample size. Future studies should include a longer timeframe of analysis or include multiple sites either across corporate structures or within geographic areas. Determining upstream factors (missed triggers) and staff training and support will improve skills in patient assessment and willingness to initiate a call for help from the RRT. The information gained from this study will identify trends and opportunities for improving the care of hospitalized patients at risk for in-hospital cardiac arrest. Additionally, it will reinforce the conceptualization that there truly is a team of experts at each patient's bedside regardless of unit specialization.en_GB
dc.date.available2011-10-28T16:16:26Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T16:16:26Z-
dc.conference.date2010en_US
dc.conference.name7th Annual Florida Magnet Research Conferenceen_US
dc.conference.hostUniversity of South Florida College of Nursingen_US
dc.conference.hostSigma Theta Tau Internationalen_US
dc.conference.hostFlorida Organization of Nurse Executivesen_US
dc.conference.locationNaples, Florida, USAen_US
dc.description7th Annual Florida Magnet Research Conference - Theme: Research at the Point of Care. Held 11-13 February 2010 at the Naples Grande Beach Resort, Naples, Florida, USA.en_US
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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