2.50
Hdl Handle:
http://hdl.handle.net/10755/211530
Type:
Research Study
Title:
VALIDATION OF THE INDICATOR RN CONCERN AS A PREDICTOR OF PATIENT DECLINE
Abstract:
Purpose: To determine if the subjective indicator of being concerned, (Concern) that RNs use as a reason to call the rapid response team, is an independent predictor of patient decline that captures a unique and valuable aspect of risk assessment for hospitalized patients. A secondary purpose is to investigate the relationship between the surveillance capacity of RNs and the use of Concern to initiate an RRT call. Background: Patient safety is a critical priority in health care organizations (1). Complications that develop during hospitalization and lead to mortality or failure to rescue are seen as a primary cause of preventable deaths (2). Signs and symptoms of clinical decline and impending code arrest are present six to eight hours prior (3, 4, 5) indicating these signs could be detected early and managed to prevent adverse events from occurring. The rapid response team (RRT) is a system that supports the bedside registered nurse (RN) by providing consultation and resources to the RN at the bedside (6) to reduce preventable deaths (7). Physiologic changes are often the reason RNs call the RRT. They also call the RRT when they have a subjective feeling of concern or are worried (Concern). An understanding of the importance of this indicator as a predictor of decline in relation to the outcomes of the RRT call is needed. Methodology: This study is a descriptive, correlational design using mixed methods to determine the salient indicators of patients at risk for decline. The setting is a large community hospital in California that was an early adopter of the RRT. A random sample of 717 patients that had an RRT achieves 90% power at a 0.05 significance level to detect a change in probability of intervention from the baseline value of 0.50 to 0.666. A cohort sample of 108 RNs who used Concern to call the RRT will be surveyed. Purposive sampling will be used to select 10 to 15 RNs as key informants for interview about their use of the indicator Concern and experience detecting patient decline. Analysis involves descriptive statistics, Pearson’s r correlation, and logistic regression to determine predictor variables. Multilevel analysis will address RNs involved in more than one RRT. Narrative data from RN interviews about their use of the indicator Concern and experience detecting patient decline will be analyzed using open coding and constant comparative technique. Results: Data analysis will be completed by February 2012. Findings will be presented. Implications: Validating the indicators associated with RRT interventions can improve systematic assessment and recognition of patients with impending decline.  Taking action when an RN identifies concerns may prevent deterioration or the development of complications. Determining if Concern is a warning that should not be ignored or minimized and validating the salient indicators of risk among hospitalized patients can help RNs with early detection and prevent delay in treatment, which may in turn, prevent code arrests and save patient lives.
Keywords:
Registered nurses; Hospitalized patients; Patient decline
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5367
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleVALIDATION OF THE INDICATOR RN CONCERN AS A PREDICTOR OF PATIENT DECLINEen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211530-
dc.description.abstractPurpose: To determine if the subjective indicator of being concerned, (Concern) that RNs use as a reason to call the rapid response team, is an independent predictor of patient decline that captures a unique and valuable aspect of risk assessment for hospitalized patients. A secondary purpose is to investigate the relationship between the surveillance capacity of RNs and the use of Concern to initiate an RRT call. Background: Patient safety is a critical priority in health care organizations (1). Complications that develop during hospitalization and lead to mortality or failure to rescue are seen as a primary cause of preventable deaths (2). Signs and symptoms of clinical decline and impending code arrest are present six to eight hours prior (3, 4, 5) indicating these signs could be detected early and managed to prevent adverse events from occurring. The rapid response team (RRT) is a system that supports the bedside registered nurse (RN) by providing consultation and resources to the RN at the bedside (6) to reduce preventable deaths (7). Physiologic changes are often the reason RNs call the RRT. They also call the RRT when they have a subjective feeling of concern or are worried (Concern). An understanding of the importance of this indicator as a predictor of decline in relation to the outcomes of the RRT call is needed. Methodology: This study is a descriptive, correlational design using mixed methods to determine the salient indicators of patients at risk for decline. The setting is a large community hospital in California that was an early adopter of the RRT. A random sample of 717 patients that had an RRT achieves 90% power at a 0.05 significance level to detect a change in probability of intervention from the baseline value of 0.50 to 0.666. A cohort sample of 108 RNs who used Concern to call the RRT will be surveyed. Purposive sampling will be used to select 10 to 15 RNs as key informants for interview about their use of the indicator Concern and experience detecting patient decline. Analysis involves descriptive statistics, Pearson’s r correlation, and logistic regression to determine predictor variables. Multilevel analysis will address RNs involved in more than one RRT. Narrative data from RN interviews about their use of the indicator Concern and experience detecting patient decline will be analyzed using open coding and constant comparative technique. Results: Data analysis will be completed by February 2012. Findings will be presented. Implications: Validating the indicators associated with RRT interventions can improve systematic assessment and recognition of patients with impending decline.  Taking action when an RN identifies concerns may prevent deterioration or the development of complications. Determining if Concern is a warning that should not be ignored or minimized and validating the salient indicators of risk among hospitalized patients can help RNs with early detection and prevent delay in treatment, which may in turn, prevent code arrests and save patient lives.en_GB
dc.subjectRegistered nursesen_GB
dc.subjectHospitalized patientsen_GB
dc.subjectPatient declineen_GB
dc.date.available2012-02-20T12:00:31Z-
dc.date.issued2012-02-20T12:00:31Z-
dc.date.accessioned2012-02-20T12:00:31Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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