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  • The impact of a nurse led rapid response system on adverse, major adverse events and activation of the medical emergency team

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    Author(s)
    Massey, Debbie
    Aitken, Leanne M
    Chaboyer, Wendy
    Griffith University Author(s)
    Chaboyer, Wendy
    Year published
    2015
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    Abstract
    AIM: To identify the relationship between one example of a rapid response system (RRS), specifically, an after-hours Clinical Team Co-Ordinator (CTC), and the incidence of Medical Emergency Team (MET) activations and, adverse and major adverse events in medical patients. METHOD: A retrospective chart audit of patients' medical records was undertaken. The intervention group consisted of 150 randomly selected medical patients admitted during three months after the introduction of the CTC after-hours service. The control group consisted of 150 randomly selected medical patients admitted before the introduction of the after-hours ...
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    AIM: To identify the relationship between one example of a rapid response system (RRS), specifically, an after-hours Clinical Team Co-Ordinator (CTC), and the incidence of Medical Emergency Team (MET) activations and, adverse and major adverse events in medical patients. METHOD: A retrospective chart audit of patients' medical records was undertaken. The intervention group consisted of 150 randomly selected medical patients admitted during three months after the introduction of the CTC after-hours service. The control group consisted of 150 randomly selected medical patients admitted before the introduction of the after-hours CTC service. Multiple logistic regression was used to determine which of the potential predictors, along with the after-hours CTC service, were associated with adverse and major adverse events. RESULTS: A total of 130 patients (n=63, 42% control; n=67, 45% intervention) exhibited physiological abnormalities that should have activated the MET yet it was only activated five times. In total there were 69 adverse events (n=32, 21% control; n=36, 25% intervention) and 25 major adverse events (n=7, 5% control; n=18, 12% intervention). There were more adverse and major adverse events identified after the introduction of the CTC after-hours service. Changes in heart rate and reduction in Glasgow Coma Scores (GCS) were significant predictors of an adverse event. A low urine output and a drop of two or more in the GCS were significant predictors of a major adverse event. CONCLUSIONS: The introduction of an after-hours CTC service in a specific clinical site was associated with an increase in the identification of adverse and major adverse events in medical patients. Further exploration of nurse-led rapid response systems should be undertaken in different clinical settings.
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    Journal Title
    Intensive and Critical Care Nursing
    Volume
    31
    Issue
    2
    DOI
    https://doi.org/10.1016/j.iccn.2014.11.005
    Copyright Statement
    © 2015 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
    Subject
    Nursing
    Acute care
    Publication URI
    http://hdl.handle.net/10072/117134
    Collection
    • Journal articles

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