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

Massey, D., Aitken, L. M. & Chaboyer, W. (2015). The impact of a nurse led rapid response system on adverse, major adverse events and activation of the medical emergency team. Intensive and Critical Care Nursing, 31(2), pp. 83-90. doi: 10.1016/j.iccn.2014.11.005

[img]
Preview
Text - Accepted Version
Available under License : See the attached licence file.

Download (113kB) | Preview
[img]
Preview
Text (Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence) - Other
Download (201kB) | Preview

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 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.

Item Type: Article
Additional Information: © 2015, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Uncontrolled Keywords: ramp up rapid response system, after- hours, patient safety, adverse events, major adverse events
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RT Nursing
Divisions: School of Health Sciences > Healthcare Education Development Unit
URI: http://openaccess.city.ac.uk/id/eprint/6983

Actions (login required)

View Item View Item

Downloads

Downloads per month over past year

View more statistics