2.50
Hdl Handle:
http://hdl.handle.net/10755/203177
Type:
Presentation
Title:
Effects of a well-functioning rapid response team (RRT)
Abstract:
(Summer Institute) Problem: In 2007, a 511 bed rural academic level one trauma instituted a RRT. There was mixed reaction among hospital leaders with the development of the team due to conflicting literature of RRT effectiveness. Therefore, a retrospective, correlational study was undertaken to determine whether earlier intervention by a well-functioning RRT reduces the incidence of cardiac arrests and improves 30 day outcomes of adult patients at Scott and White Memorial Hospital. Evidence: Data collection will not be complete until Summer, 2011. However, a total of 300 charts have been reviewed with preliminary evidence supporting RRT effectiveness. Strategy: Based on preliminary findings the hospital administration has instituted RRT system-wide. Practice Change: RRT consisting of a critical care nurse and a respiratory therapist was instituted in January, 2007 to provide coverage 24 hours a day, 7 days a week. Evaluation: The current model of the RRT has been in place for four years with a decline in cardiac arrest outside of the ICU and ER. Results: The results have been numerous and include: implementation of a pediatric and family activated RRT, physician awareness in leadership roles, improved collaborative relationships, decrease in cardiac arrests, and decreased mortality. Recommendations: An additional study is currently underway to determine if strict ICU discharge criteria should be established based on patients who experience a RRT within 24 hours after ICU discharge. Lessons learned: Implementing a change within an entire hospital system can be a challenge and requires the support of multiple stakeholders. However, considering the positive impact RRT can have on patient outcomes and on staff satisfaction facilitates navigating and overcoming making the change. Bibliography: American Society of Anesthesiologists. (n.d.). Retrieved October 21, 2008, from: http://www.asahg.org/clinical/physicalstatus.htm. Bellomo, R., Goldsmith, D., Uchino, S., Buckmaster, J., Hart, G., Opdam, H….Gutteridge, G. (2003). A prospective before-and-after trial of a medical emergency team. Medical Journal of Australia. 179(6), 283-287. Bellomo, R., Goldsmith, D., Uchino, S., Buckmaster, J., Hart, G., Opdam, H….Gutteridge, G. (2004). Prospective controlled trial of effect of medical emergency team on postoperative morbidity and mortality rates. Critical Care Medicine. 32(4), 916-921. Buist, M., Moore, G., Bernard, S., Waxman, B., Anderson, J., & Nguyen, T. (2002). Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: Preliminary study. BMJ. 324(7334), 287-390. DeVita, M., Braithwaite, R., Mahidhara, R., Stuart, A., Foraida, M., Simmons, R., et al. (2004). Use of medical emergency team responses to reduce hospital cardiopulmonary arrests. Quality Safety Health Care. 13(4), 251-254. Galhotra, S., DeVita, M., Simmons, R., & Dew, M. (2007). Mature rapid response system and potentially avoidable cardiopulmonary arrests in hospital. Quality and Safety in Health Care. 16(4), 260-265. Hillman, K., Chen, J., Cretikos, M, et al, and MERIT Study investigators. Introduction of the medical emergency team (MET) system: A cluster-randomised controlled trial. Lancet. 365(9477), 2091-2097. Institute of Medicine. (2000). To err is human: Building a safer health system. Washington, DC: National Academy Press. Jones, D., Bellomo, R., Bates, S., Warrillow, S., Goldsmith, D., Opdam, H. et al. (2005). Long term effect of a medical emergency team on cardiac arrests in a teaching hospital. Critical Care. 9(6), 808-815. Jones, D., Egi, M., Bellomo, R., & Goldsmith, D. (2007). Effect of the medical emergency team on long-term mortality following major surgery. RetrievedMarch 3, 2008, from http://ccforum.com/contentl11/1/R1 Kerridge, R., & Saul, P. (2003). The medical emergency team, evidence-based medicine and ethics. MJA. 179(6), 313-315. Leape, L., Lawthers, A., Brennan, T., & Johnson, W. (1993). Preventing medical injury. Quality Review Bulletin. 19(5), 144-149. Lemeshow, S., Teres, D., Avrunin, J., & Gage, R. (1988). Mortality prediction model­admission. Critical Care Medicine. 16(5), 470-477. Retrieved October 21, 2008,from http://www.icumedicus.com/icu_scores/mpm48.php#anchor1 Maccioli, G., & Winters, B. (2006). Rapid response teams: The role for anesthesiologist and anesthesiology-based intensivists. Retrieved March 3, 2008, from http://www.asahq.org/Newsletters/2006/04 06.html Nowak, J, & Brilli, R. (2007). Pediatric rapid response teams. JAMA.298(19), 2311-2312. Polit, D., Beck, C. (2004). Nursing Research: Principles and Methods (7th ed.). Lippincott Williams & Wilkins: Philadelphia. Sebat, F., Musthafa, A., Johnson, D., Kramer, A., Shoffner, D., Eliason, M., et al. (2007). Effect of a rapid response system for patients in shock on time to treatment and mortality during 5 years. Critical Care Medicine. 35(11), 2568-2575. Sharek, P., Parast, L., Leong, K., Coombs, J., Roth, & Stephen, J. (2007). Effect of a rapid response team on hospital-wide morality and code rates outside the ICU in a children's hospital. JAMA. 298(19), 2267-2274. Winters, B., Cuong, J., Hunt, E., Guallar, E., Berenholtz, S., & Pronovost, P. (2007). Rapid response systems: A systematic review. Critical Care Medicine. 35(5}, 1238-1243. [© Academic Center for Evidence-Based Practice, 2011. http://www.acestar.uthscsa.edu]
Keywords:
Effects; RRT
Repository Posting Date:
16-Jan-2012
Date of Publication:
3-Jan-2012
Sponsors:
UTHSCSA Summer Institute

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEffects of a well-functioning rapid response team (RRT)en_GB
dc.identifier.urihttp://hdl.handle.net/10755/203177-
dc.description.abstract(Summer Institute) Problem: In 2007, a 511 bed rural academic level one trauma instituted a RRT. There was mixed reaction among hospital leaders with the development of the team due to conflicting literature of RRT effectiveness. Therefore, a retrospective, correlational study was undertaken to determine whether earlier intervention by a well-functioning RRT reduces the incidence of cardiac arrests and improves 30 day outcomes of adult patients at Scott and White Memorial Hospital. Evidence: Data collection will not be complete until Summer, 2011. However, a total of 300 charts have been reviewed with preliminary evidence supporting RRT effectiveness. Strategy: Based on preliminary findings the hospital administration has instituted RRT system-wide. Practice Change: RRT consisting of a critical care nurse and a respiratory therapist was instituted in January, 2007 to provide coverage 24 hours a day, 7 days a week. Evaluation: The current model of the RRT has been in place for four years with a decline in cardiac arrest outside of the ICU and ER. Results: The results have been numerous and include: implementation of a pediatric and family activated RRT, physician awareness in leadership roles, improved collaborative relationships, decrease in cardiac arrests, and decreased mortality. Recommendations: An additional study is currently underway to determine if strict ICU discharge criteria should be established based on patients who experience a RRT within 24 hours after ICU discharge. Lessons learned: Implementing a change within an entire hospital system can be a challenge and requires the support of multiple stakeholders. However, considering the positive impact RRT can have on patient outcomes and on staff satisfaction facilitates navigating and overcoming making the change. Bibliography: American Society of Anesthesiologists. (n.d.). Retrieved October 21, 2008, from: http://www.asahg.org/clinical/physicalstatus.htm. Bellomo, R., Goldsmith, D., Uchino, S., Buckmaster, J., Hart, G., Opdam, H….Gutteridge, G. (2003). A prospective before-and-after trial of a medical emergency team. Medical Journal of Australia. 179(6), 283-287. Bellomo, R., Goldsmith, D., Uchino, S., Buckmaster, J., Hart, G., Opdam, H….Gutteridge, G. (2004). Prospective controlled trial of effect of medical emergency team on postoperative morbidity and mortality rates. Critical Care Medicine. 32(4), 916-921. Buist, M., Moore, G., Bernard, S., Waxman, B., Anderson, J., & Nguyen, T. (2002). Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: Preliminary study. BMJ. 324(7334), 287-390. DeVita, M., Braithwaite, R., Mahidhara, R., Stuart, A., Foraida, M., Simmons, R., et al. (2004). Use of medical emergency team responses to reduce hospital cardiopulmonary arrests. Quality Safety Health Care. 13(4), 251-254. Galhotra, S., DeVita, M., Simmons, R., & Dew, M. (2007). Mature rapid response system and potentially avoidable cardiopulmonary arrests in hospital. Quality and Safety in Health Care. 16(4), 260-265. Hillman, K., Chen, J., Cretikos, M, et al, and MERIT Study investigators. Introduction of the medical emergency team (MET) system: A cluster-randomised controlled trial. Lancet. 365(9477), 2091-2097. Institute of Medicine. (2000). To err is human: Building a safer health system. Washington, DC: National Academy Press. Jones, D., Bellomo, R., Bates, S., Warrillow, S., Goldsmith, D., Opdam, H. et al. (2005). Long term effect of a medical emergency team on cardiac arrests in a teaching hospital. Critical Care. 9(6), 808-815. Jones, D., Egi, M., Bellomo, R., & Goldsmith, D. (2007). Effect of the medical emergency team on long-term mortality following major surgery. RetrievedMarch 3, 2008, from http://ccforum.com/contentl11/1/R1 Kerridge, R., & Saul, P. (2003). The medical emergency team, evidence-based medicine and ethics. MJA. 179(6), 313-315. Leape, L., Lawthers, A., Brennan, T., & Johnson, W. (1993). Preventing medical injury. Quality Review Bulletin. 19(5), 144-149. Lemeshow, S., Teres, D., Avrunin, J., & Gage, R. (1988). Mortality prediction model­admission. Critical Care Medicine. 16(5), 470-477. Retrieved October 21, 2008,from http://www.icumedicus.com/icu_scores/mpm48.php#anchor1 Maccioli, G., & Winters, B. (2006). Rapid response teams: The role for anesthesiologist and anesthesiology-based intensivists. Retrieved March 3, 2008, from http://www.asahq.org/Newsletters/2006/04 06.html Nowak, J, & Brilli, R. (2007). Pediatric rapid response teams. JAMA.298(19), 2311-2312. Polit, D., Beck, C. (2004). Nursing Research: Principles and Methods (7th ed.). Lippincott Williams & Wilkins: Philadelphia. Sebat, F., Musthafa, A., Johnson, D., Kramer, A., Shoffner, D., Eliason, M., et al. (2007). Effect of a rapid response system for patients in shock on time to treatment and mortality during 5 years. Critical Care Medicine. 35(11), 2568-2575. Sharek, P., Parast, L., Leong, K., Coombs, J., Roth, & Stephen, J. (2007). Effect of a rapid response team on hospital-wide morality and code rates outside the ICU in a children's hospital. JAMA. 298(19), 2267-2274. Winters, B., Cuong, J., Hunt, E., Guallar, E., Berenholtz, S., & Pronovost, P. (2007). Rapid response systems: A systematic review. Critical Care Medicine. 35(5}, 1238-1243. [© Academic Center for Evidence-Based Practice, 2011. http://www.acestar.uthscsa.edu]en_GB
dc.subjectEffectsen_GB
dc.subjectRRTen_GB
dc.date.available2012-01-16T11:01:39Z-
dc.date.issued2012-01-03en_GB
dc.date.accessioned2012-01-16T11:01:39Z-
dc.description.sponsorshipUTHSCSA Summer Instituteen_GB
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