Dedicated, Proactive, Nurse Practitioner Rapid Response Team Eliminating Barriers

Burrell, Erin; Kapu, April N.; Huggins, Elizabeth; Cole, Katie; Fitzsimmons, Jennifer; Collins, Nina; Weavind, Liza

doi:10.1016/j.nurpra.2019.07.013

Cited by 7 publications

(5 citation statements)

References 7 publications

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“…Burrell et al. [ 26 ], reported that, despite RRS having come a long way to becoming a routine part of clinical practice to detect and respond to deteriorating patients, many RRS activations do not occur when indicated. Burrell et al., reported that ward nurses may still be reluctant to activate the RRS due to fear of reprimand, but introducing a proactive, dedicated team of rapid responder nurses would facilitate inter-professional communication, increase the RRS activations to allow early detection and management of deteriorating patients, reducing ICU admissions and patient adverse events.…”

Section: Discussionmentioning

confidence: 99%

Vital signs and early warning score monitoring: perceptions of clinical staff about current practices and introducing an electronic rapid response system

Ullah

Baig²,

GholamHosseini

et al. 2022

Heliyon

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Section: Discussionmentioning

confidence: 99%

Vital signs and early warning score monitoring: perceptions of clinical staff about current practices and introducing an electronic rapid response system

Ullah

Baig²,

GholamHosseini

et al. 2022

Heliyon

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“…The balance of covariates after propensity matching confirms that both groups are comparable. All other studies either used a retrospective before and after design, focused on recognition of systemic inflammatory response syndrome, measured post-ICU discharge interventions instead of MET call leadership, did not have ICUR-led MET calls for comparison or measured active surveillance for deteriorating patients rather than MET call leadership [9][10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

“…To reduce disruptions to the critical care staff with defined roles, a small proportion of healthcare services have introduced trained nurse practitioners (NP) specifically employed to lead MET call response. The growing expertise in acute management of deteriorating patients outside the ICUs and the evolving role of NPs has resulted in examination of the role of NPs in leading MET response [9][10][11][12][13][14]. To our knowledge, clinical outcomes between NP-led MET calls and intensive care unit registrar, a junior doctor in training (ICUR)-led MET calls have not been compared.…”

Section: Introductionmentioning

confidence: 99%

Comparison of clinical outcomes between nurse practitioner and registrar-led medical emergency teams: a propensity-matched analysis

et al. 2021

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Objective Medical emergency teams (MET) are mostly led by physicians. Some hospitals are currently using nurse practitioners (NP) to lead MET calls. These are no studies comparing clinical outcomes between these two care models. To determine whether NP-led MET calls are associated with lower risk of acute patient deterioration, when compared to intensive care (ICU) registrar (ICUR)-led MET calls. Methods The composite primary outcome included recurrence of MET call, occurrence of code blue or ICU admission within 24 h. Secondary outcomes were mortality within 24 h of MET call, length of hospital stay, hospital mortality and proportion of patients discharged home. Propensity score matching was used to reduce selection bias from confounding factors between the ICUR and NP group. Results A total of 1343 MET calls were included (1070 NP, 273 ICUR led). On Univariable analysis, the incidence of the primary outcome was higher in ICUR-led MET calls (26.7% vs. 20.6%, p = 0.03). Of the secondary outcome measures, mortality within 24 h (3.4% vs. 7.7%, p = 0.002) and hospital mortality (12.7% vs. 20.5%, p = 0.001) were higher in ICUR-led MET calls. Propensity score-matched analysis of 263 pairs revealed the composite primary outcome was comparable between both groups, but NP-led group was associated with reduced risk of hospital mortality (OR 0.57, 95% CI 0.35–0.91, p = 0.02) and higher likelihood of discharge home (OR 1.55, 95% CI 1.09–2.2, p = 0.015). Conclusion Acute patient deterioration was comparable between ICUR- and NP-led MET calls. NP-led MET calls were associated with lower hospital mortality and higher likelihood of discharge home.

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“…The rapid response team is typically coordinated and led by the intensive care unit (ICU). Generally, the rapid response team consists of an ICU physician, critical care nurse, general medicine physicians, and in more recent times a nurse practitioner 5,6 . Rapid response systems provide a safety net for ward-based nurses to ensure patient safety before life-threatening deterioration occurs 7,8 .…”

Section: Rapid Response Systemmentioning

confidence: 99%

Exploration of Ward-Based Nurses’ Perspectives on Their Preparedness to Recognize Clinical Deterioration: A Scoping Review

Mikhail

King

2022

J Patient Saf

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BackgroundDespite initiatives in the early recognition of clinical deterioration, the incidence of failure to recognize clinical deterioration in patients continues to occur contributing to the ongoing rise of in-hospital mortality and morbidity.ObjectiveThe aim of the study was to explore and appraise the research evidence that related to ward-based nurses’ preparedness to recognize the clinically deteriorating patient.MethodsA scoping review was undertaken as this approach enabled the researchers to investigate the breadth of the available evidence through broad inclusion criteria. A comprehensive database search was conducted through the Cochrane Library; Cumulative Index to Nursing and Allied Health Literature; MEDLINE; ProQuest; PubMed; and Wiley Online Library. Each article was critically appraised and analyzed using a critical appraisal tool and thematic analysis, respectively. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews checklist.ResultsTwelve primary sources of literature met the eligibility criteria. Through thematic analyses 6 primary themes were identified: implication of experience on preparedness; interprofessional and intraprofessional relationships; knowledge of calling criteria, process and procedures; requirement for a supportive system and culture; existence of hierarchy within healthcare impacting care; and clinical deterioration as an education opportunity.ConclusionsThis review identified central issues that impacted on ward-based nurses’ preparedness. Further development of collaborative, supportive professional relationships across-and-within disciplines is needed. Effective use of clinical deterioration situations as educational opportunities would also assist nurses’ preparedness through skill and knowledge development. However, more research evidence will be needed because of the limited data available on the topic.

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Dedicated, Proactive, Nurse Practitioner Rapid Response Team Eliminating Barriers

Cited by 7 publications

References 7 publications

Vital signs and early warning score monitoring: perceptions of clinical staff about current practices and introducing an electronic rapid response system

Vital signs and early warning score monitoring: perceptions of clinical staff about current practices and introducing an electronic rapid response system

Comparison of clinical outcomes between nurse practitioner and registrar-led medical emergency teams: a propensity-matched analysis

Exploration of Ward-Based Nurses’ Perspectives on Their Preparedness to Recognize Clinical Deterioration: A Scoping Review

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