Failure to activate the in-hospital emergency team: causes and outcomes

Barbosa, Vera; Gomes, Ernestina; Vaz, Senio; Azevedo, Gustavo Y. S.; Fernandes, G.; Ferreira, Amélia; Araújo, Rui Esteves

doi:10.5935/0103-507x.20160075

Cited by 16 publications

(16 citation statements)

References 22 publications

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“…Since nursing is in the front line of care, considering that it organizes, prepares, and administers medication, guaranteeing that patients receive safe assistance is part of its legal responsibility (22) . For such, during an emergency event, the medication drawer is required to contain visible divisions and labels for its organization; also, medication should not be expired (2) . Medications due to expire within three months should be substituted, except when unavailable in the hospital.…”

Section: Discussionmentioning

confidence: 99%

“…To guarantee safe treatment, it is necessary to periodically check the CC to make sure that medications are in their due compartments and not expired, avoiding errors during administration (7) . This indicates the importance of a checklist for verifying items and controlling equipment quantity, integrity, and expiration, so as to replace it and guarantee that, during CPR maneuvers, all equipment is present and fit for use (2,14) . In addition to providing due identification and verifying medication, it is crucial that the multiprofessional team are familiar with the CC and participate in constant updates on patient treatment in acute situations (14) .…”

Section: Discussionmentioning

confidence: 99%

“…Treating CPA in the hospital environment requires the multiprofessional team to be quick in recognizing clinical signs and starting Cardiopulmonary Resuscitation (CPR) maneuvers (2) . The availability of equipment and medication for patient assistance is crucial during this event; these are provided through a mobile cabinet called Crash Cart (CC), which must be present in all hospital units.…”

Section: Introductionmentioning

confidence: 99%

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Analyzing the operational conditions of crash carts in clinical and surgical hospitalization units

Silva

Lazzari

Reisdorfer

et al. 2021

Rev. esc. enferm. USP

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Objective: To evaluate the operational conditions of crash carts in all clinical and surgical hospitalization units of public hospitals in a region in Southern Brazil. Method: Quantitative, cross-sectional study to evaluate crash carts in adult clinical and surgical hospitalization units. The data were collected through a checklist containing 16 continuous variables. Results: Nineteen crash carts in nineteen units were evaluated. Analysis shows that the most frequent problems were excess of equipment and its lack of organization, medication in incorrect compartments and/or with no identification, and inappropriate environment for transportation. Conclusion: The most relevant factors that possibly interfere with the operational conditions of crash carts are directly related to the organization and management of material resources, which may lead to the reduction of its functionality during patient care. Such problem may be solved by readjusting items and performing frequent verification.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Analyzing the operational conditions of crash carts in clinical and surgical hospitalization units

Silva

Lazzari

Reisdorfer

et al. 2021

Rev. esc. enferm. USP

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“…( 15 ) The failure of the detection of this deterioration can reduce the effectiveness of RRTs. ( 16 ) Additionally, RRTs were included as the fifth link in the chain of survival described in the Advanced Cardiac Life Support Subcommittee statement. ( 17 , 18 )…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of rapid response teams in reducing intrahospital cardiac arrests and deaths: a systematic review and meta-analysis

Rocha¹,

Alcantara²,

Rocha³

et al. 2018

Revista Brasileira De Terapia Intensiva

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ObjectiveTo evaluate the effectiveness of rapid response teams using early identification of clinical deterioration in reducing the occurrence of in-hospital mortality and cardiorespiratory arrest.Data sourcesThe MEDLINE, LILACS, Cochrane Library, Center for Reviews and Dissemination databases were searched.Study selectionWe included studies that evaluated the effectiveness of rapid response teams in adult hospital units, published in English, Portuguese, or Spanish, from 2000 to 2016; systematic reviews, clinical trials, cohort studies, and prepost ecological studies were eligible for inclusion. The quality of studies was independently assessed by two researchers using the Newcastle-Ottawa, modified Jadad, and Assessment of Multiple Systematic Reviews scales.Data extractionsThe results were synthesized and tabulated. When risk measures were reported by the authors of the included studies, we estimated effectiveness as 1-RR or 1-OR. In pre-post studies, we estimated effectiveness as the percent decrease in rates following the intervention.ResultsOverall, 278 studies were identified, 256 of which were excluded after abstract evaluation, and two of which were excluded after full text evaluation. In the meta-analysis of the studies reporting mortality data, we calculated a risk ratio of 0.85 (95%CI 0.76 - 0.94); and for studies reporting cardiac arrest data the estimated risk ratio was 0.65 (95%CI 0.49 - 0.87). Evidence was assessed as low quality due to the high heterogeneity and risk of bias in primary studies.ConclusionWe conclude that rapid response teams may reduce in-hospital mortality and cardiac arrests, although the quality of evidence for both outcomes is low.

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“…Failure of the afferent limb of the RRT, including recognition of clinical deterioration and knowing how to and actually activating the RRT, has been associated with a higher incidence of cardiac arrest and an increased mortality rate. 11 Thus, the simple availability of a highly skilled EOC team is not by itself effective, and attention must be paid to whether EOC is performed appropriately and efficiently. Different barriers may exist to RRT activation, potentially explaining some of the variation within outcomes associated with RRT implementation between different hospitals.…”

mentioning

confidence: 99%

Development and Validation of the Pediatric Resuscitation and Escalation of Care Self-Efficacy Scale

Zurca

Olsen

Lucas

2019

Hospital Pediatrics

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To validate a scale to assess pediatric providers' resuscitation and escalation of care selfefficacy and assess which provider characteristics and experiences may contribute to self-efficacy. METHODS: Cross-sectional cohort study performed at an academic children's hospital. Pediatric nurses, respiratory therapists, and residents completed the Generalized Self-Efficacy Scale (GSES) and Pediatric Resuscitation Self-Efficacy Scale (PRSES) as well as a survey assessing their experiences with pediatric escalation of care. RESULTS: Four hundred participants completed the GSES and PRSES. A total of 338 completed the survey, including 262 nurses, 51 respiratory therapists, and 25 residents. Cronbach a for the PRSES was 0.905. A factor analysis revealed 2 factors within the scale, with items grouped on the basis of expertise required. Multiple logistic regression analyses controlling for GSES score, number of code blue events participated, number of code blue events activated, number of rapid response team events participated, number of rapid response team response events called, performance on a knowledge assessment of appropriate escalation of care, and years of experience demonstrated that PRSES performance was significantly associated with GSES scores and number of escalation of care events (code blue and rapid response) previously participated in (R 2 5 0.29, P , .001). CONCLUSIONS: The PRSES can be used to assess pediatric providers' pediatric resuscitation selfefficacy and could be used to evaluate pediatric escalation of care interventions. Pediatric resuscitation self-efficacy is significantly associated with number of previous escalation of care experiences. In future studies, researchers should focus on assessing the impact of increased exposures to escalation of care, potentially via mock codes, to accelerate the acquisition of resuscitation self-efficacy.

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Failure to activate the in-hospital emergency team: causes and outcomes

Cited by 16 publications

References 22 publications

Analyzing the operational conditions of crash carts in clinical and surgical hospitalization units

Analyzing the operational conditions of crash carts in clinical and surgical hospitalization units

Effectiveness of rapid response teams in reducing intrahospital cardiac arrests and deaths: a systematic review and meta-analysis

Development and Validation of the Pediatric Resuscitation and Escalation of Care Self-Efficacy Scale

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