Nursing and Medical Staff Perceptions of a Hospital-Based Medical Emergency Response Team

2.50
Hdl Handle:
http://hdl.handle.net/10755/601962
Category:
Full-text
Format:
Text-based Document
Type:
Presentation
Title:
Nursing and Medical Staff Perceptions of a Hospital-Based Medical Emergency Response Team
Other Titles:
Global Issues Within Hospital Facilities [Session]
Author(s):
Booker, Catriona Anne; Douglas, Clint; Osborne, Sonya R.; Fox, Robyn L.; Richter, Kathleen Patrica; Collier, Thea-Grace
Lead Author STTI Affiliation:
Phi Delta-at-Large
Author Details:
Catriona Anne Booker, RN, RM, Catriona.Booker@health.qld.gov.au; Clint Douglas, RN; Sonya R. Osborne, RN, GradCert (Periop Nsg), GradCert (HigherEd); Robyn L. Fox, RN, RM, GradCertMng (Mng QH), GradCertMng (HRM), DipNrsEduc; Kathleen Patrica Richter, RN, GradDip (HlthPro); Thea-Grace Collier, RN, GradCert (ICU)
Abstract:
Session presented on Saturday, July 25, 2015: Purpose: Timely recognition and appropriate response to clinical deterioration has been at the forefront of international safety and quality agendas. Rapid response systems have been widely implemented to improve patient outcomes, yet evidence is inconclusive in confirming the effectiveness of these approaches consistently across a range of settings [1, 2]. ??Other studies have identified rapid response teams are often underused by staff [3, 4]. The purpose of this study was to explore and compare nursing and medical staff perceptions of a mature rapid response system at a large tertiary hospital using the Australian Commission on Safety and Quality in Health Care benchmarking tool. Specifically, the study objectives were to examine perceptions of barriers to Medical Emergency Response Team (MERT) activation, effectiveness of the MERT in response to clinical deterioration, and effectiveness of teamwork and communication during a MERT call. Methods: A single site, cross-sectional survey design was used to explore staff perceptions of the MERT. This study was part of a larger program of research exploring nursing patient assessment practices in the acute care setting. The single-centre study was conducted at a 929-bed quaternary and tertiary referral teaching hospital located in Southeast Queensland, Australia providing services to diverse clinical specialities. The sample included 434 registered nurses (RNs) and 190 medical staff involved in the care of patients at risk of clinical deterioration from a sampling frame of 40 clinical units. Results: ??Overall, while both groups rated the MERT positively, RNs perceived the MERT as more effective in managing clinical deterioration (p = .04) and perceived greater MERT teamwork and communication (p = .02) compared to their medical colleagues. Interestingly, 70.3% of RNs and 70.1% of medical staff indicated they would contact the patient???s treating physician before activating the MERT. Both groups similarly rated perceived barriers to MERT activation as relatively low overall. A significant minority of RNs (17.1%) and a smaller proportion of medical staff (7.9%) were reluctant to activate the MERT because they feared criticism if their patient was not found to be critically unwell (p< .01). ??Conclusion: Quality improvement and patient safety are imperative clinical targets supported by policy, patient advocacy, and healthcare professional groups. This project is a collaborative partnership between health service managers, clinical managers, clinicians and university and clinical researchers that has formed in response to this significant health service problem. Findings from this study will contribute to our understanding of integral factors related to capacity to rescue of clinical frontline staff, patient safety, and the rate of failure to rescue of patients in acute care wards. Further research is needed to determine which improvement strategies are more consistently effective and sustainable in recognition and response to clinical deterioration that incorporates perceptions of frontline staff. References 1. Chan PS, Jain R, Nallmothu BK, Berg RA, Sasson C (2010). Rapid Response Teams. A systematic review and meta-analysis. Archives of Internal Medicine, 170(1):18-26. 2. Winters BD, Weaver SJ, Pfoh ER, Yang T, Pham JC, Dy SM (2013). Rapid-response systems as a patient safety strategy: a systematic review. Annals of Internal Medicine, 5; 158 (5 Pt 2): 417-25. 3. Salamonson, Y., van Heere, B., Everett, B., & Davidson, P. (2006). Voices from the floor: nurses??? perceptions of the medical emergency team. Intensive and Critical Care Nursing, 22, 138-143. doi: 10.1016/j.iccn.2005.10.002 4. Massey D, Aitken LM, Chaboyer W (2010). Literature review: do rapid response systems reduce the incidence of major adverse events in the deteriorating ward patient? Journal of Clinical Nursing, 19, 3260???3273 doi: 10.1111/j.1365-2702.2010.03394.x
Keywords:
Clinical deterioration; Response teams; Nurses' perceptions
Repository Posting Date:
17-Mar-2016
Date of Publication:
17-Mar-2016 ; 17-Mar-2016
Other Identifiers:
INRC15E07
Conference Date:
2015
Conference Name:
26th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
San Juan, Puerto Rico
Description:
Research Congress 2015 Theme: Question Locally, Engage Regionally, Apply Globally. Held at the Puerto Rico Convention Center.

Full metadata record

DC FieldValue Language
dc.language.isoenen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePresentationen
dc.titleNursing and Medical Staff Perceptions of a Hospital-Based Medical Emergency Response Teamen
dc.title.alternativeGlobal Issues Within Hospital Facilities [Session]en
dc.contributor.authorBooker, Catriona Anneen
dc.contributor.authorDouglas, Clinten
dc.contributor.authorOsborne, Sonya R.en
dc.contributor.authorFox, Robyn L.en
dc.contributor.authorRichter, Kathleen Patricaen
dc.contributor.authorCollier, Thea-Graceen
dc.contributor.departmentPhi Delta-at-Largeen
dc.author.detailsCatriona Anne Booker, RN, RM, Catriona.Booker@health.qld.gov.au; Clint Douglas, RN; Sonya R. Osborne, RN, GradCert (Periop Nsg), GradCert (HigherEd); Robyn L. Fox, RN, RM, GradCertMng (Mng QH), GradCertMng (HRM), DipNrsEduc; Kathleen Patrica Richter, RN, GradDip (HlthPro); Thea-Grace Collier, RN, GradCert (ICU)en
dc.identifier.urihttp://hdl.handle.net/10755/601962-
dc.description.abstractSession presented on Saturday, July 25, 2015: Purpose: Timely recognition and appropriate response to clinical deterioration has been at the forefront of international safety and quality agendas. Rapid response systems have been widely implemented to improve patient outcomes, yet evidence is inconclusive in confirming the effectiveness of these approaches consistently across a range of settings [1, 2]. ??Other studies have identified rapid response teams are often underused by staff [3, 4]. The purpose of this study was to explore and compare nursing and medical staff perceptions of a mature rapid response system at a large tertiary hospital using the Australian Commission on Safety and Quality in Health Care benchmarking tool. Specifically, the study objectives were to examine perceptions of barriers to Medical Emergency Response Team (MERT) activation, effectiveness of the MERT in response to clinical deterioration, and effectiveness of teamwork and communication during a MERT call. Methods: A single site, cross-sectional survey design was used to explore staff perceptions of the MERT. This study was part of a larger program of research exploring nursing patient assessment practices in the acute care setting. The single-centre study was conducted at a 929-bed quaternary and tertiary referral teaching hospital located in Southeast Queensland, Australia providing services to diverse clinical specialities. The sample included 434 registered nurses (RNs) and 190 medical staff involved in the care of patients at risk of clinical deterioration from a sampling frame of 40 clinical units. Results: ??Overall, while both groups rated the MERT positively, RNs perceived the MERT as more effective in managing clinical deterioration (p = .04) and perceived greater MERT teamwork and communication (p = .02) compared to their medical colleagues. Interestingly, 70.3% of RNs and 70.1% of medical staff indicated they would contact the patient???s treating physician before activating the MERT. Both groups similarly rated perceived barriers to MERT activation as relatively low overall. A significant minority of RNs (17.1%) and a smaller proportion of medical staff (7.9%) were reluctant to activate the MERT because they feared criticism if their patient was not found to be critically unwell (p< .01). ??Conclusion: Quality improvement and patient safety are imperative clinical targets supported by policy, patient advocacy, and healthcare professional groups. This project is a collaborative partnership between health service managers, clinical managers, clinicians and university and clinical researchers that has formed in response to this significant health service problem. Findings from this study will contribute to our understanding of integral factors related to capacity to rescue of clinical frontline staff, patient safety, and the rate of failure to rescue of patients in acute care wards. Further research is needed to determine which improvement strategies are more consistently effective and sustainable in recognition and response to clinical deterioration that incorporates perceptions of frontline staff. References 1. Chan PS, Jain R, Nallmothu BK, Berg RA, Sasson C (2010). Rapid Response Teams. A systematic review and meta-analysis. Archives of Internal Medicine, 170(1):18-26. 2. Winters BD, Weaver SJ, Pfoh ER, Yang T, Pham JC, Dy SM (2013). Rapid-response systems as a patient safety strategy: a systematic review. Annals of Internal Medicine, 5; 158 (5 Pt 2): 417-25. 3. Salamonson, Y., van Heere, B., Everett, B., & Davidson, P. (2006). Voices from the floor: nurses??? perceptions of the medical emergency team. Intensive and Critical Care Nursing, 22, 138-143. doi: 10.1016/j.iccn.2005.10.002 4. Massey D, Aitken LM, Chaboyer W (2010). Literature review: do rapid response systems reduce the incidence of major adverse events in the deteriorating ward patient? Journal of Clinical Nursing, 19, 3260???3273 doi: 10.1111/j.1365-2702.2010.03394.xen
dc.subjectClinical deteriorationen
dc.subjectResponse teamsen
dc.subjectNurses' perceptionsen
dc.date.available2016-03-17T13:00:13Zen
dc.date.issued2016-03-17-
dc.date.issued2016-03-17en
dc.date.accessioned2016-03-17T13:00:13Zen
dc.conference.date2015en
dc.conference.name26th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationSan Juan, Puerto Ricoen
dc.descriptionResearch Congress 2015 Theme: Question Locally, Engage Regionally, Apply Globally. Held at the Puerto Rico Convention Center.en
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