Performance of patient acuity rating by rapid response team nurses for predicting short-term prognosis

Kim, Hyung Jun; Min, Hyun Ju; Lee, Dong-Seon; Choi, Yun Young; Yoon, Miae; Lee, Da Yun; Song, In Ae; Cho, Jun Yeun; Cho, Young Jae; Jo, You Hwan; Yoon, Ho Il; Lee, Jae Ho; Lee, Choon Taek; Lee, Yeon Joo

doi:10.1371/journal.pone.0225229

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…Nevertheless, they referred to criteria such as the Braden Scale to determine the risk of pressure ulcers and the Morse Fall Risk Assessment to predict certain conditions. Kim et al (39) point out in their study that although the warning scores of these criteria may be useful in identifying at-risk patients, direct examinations and ongoing surveillance by health care providers should be emphasized (39).…”

Section: Discussionmentioning

confidence: 99%

Situation awareness in intensive care unit nurses: A qualitative directed content analysis

Ghaderi

Esmaeili

Ebadi

2022

Front. Public Health

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BackgroundSituation awareness (SA) is an essential cognitive construct to create positive patient safety outcomes. SA of the nurses in the intensive care unit (ICU), where conditions may change rapidly, is particularly important. The present study aimed to explain the perception and experience of SA in ICU nurses based on Endsley's SA model.Materials and methodsThis qualitative directed content analysis was conducted on nurses in six hospitals in Tehran, Iran, from December 2020 to July 2021. Twenty-seven ICU nurses were selected using purposive sampling. Data were collected by semi-structured interviews and field observations. The data were analyzed based on the Elo and Kyngas method modified by Assarroudi et al. COREQ checklist was used to report the research.ResultsThe concept of SA in ICU nurses, based on Endsley's model, includes perception of patients' clinical cues, perception of the human environment, perception of the physical environment, and perception of the organizational environment as generic categories of the perception of the elements in the environment. SA in ICU nurses also includes the main categories of comprehension the current situation through a sense of salience and interpretation of cues and projection the future situation through the prediction of patient status into the near future and environmental foresight.ConclusionFindings have further developed the concept of SA in ICU nurses based on Endsley's SA model. The insights and knowledge gained from this study can be useful for future practice, education, and research on SA among ICU nurses.

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Section: Discussionmentioning

confidence: 99%

Situation awareness in intensive care unit nurses: A qualitative directed content analysis

Ghaderi

Esmaeili

Ebadi

2022

Front. Public Health

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“…Therefore, the primary responder needs to determine whether the alarm is clinically important and requires immediate escalation to a higher level of management, or a false alarm. In our hospital, we studied the effectiveness of subjective assessment (patient acuity rating scale) of the triggered patient by experienced RRT nurses and confirmed that the subjective assessment scale of RRT nurses was superior to single parameter triggering or multi-parameter EWS in predicting the patient’s short term prognosis [ 31 , 32 ]. This result shows that an experienced and well-trained primary responder is crucial to an RRT.…”

Section: Key Strategies For the Efferent Limb: Qualified Primary Responders And Dedicated Physiciansmentioning

confidence: 93%

Strategies for successful implementation and permanent maintenance of a rapid response system

Song

Lee

2021

Korean J Intern Med

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Rapid response systems (RRSs) have been introduced to intervene with patients experiencing non-code medical emergencies and operate widely around the world. An RRS has four components: an afferent limb, an efferent limb, quality improvement, and administration. A proper triggering system, a hospital culture that embraces the RRS from the afferent limb, experienced primary responders, and dedicated physicians from the efferent limb are key for successful implementation. After initial implementation, quality improvement through objective outcome measures and self-evaluation are crucial, which lead to a better outcome when this process is well performed. Furthermore, better outcomes lead to more investment, which is essential for effective development of the system. The RRS is successfully maintained when these four components are closely interconnected.

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“…( 7 ) Recent studies have shown high variability in the accuracy of this score, which has led to uncertainty regarding its use. ( 2 , 4 , 9 , 10 ) Its role in the inter- or intrahospital transfer of patients is even more undefined. Although it has been applied in interhospital pretransfer, ( 11 - 13 ) its use at the time of transfer between sectors of the same hospital has not yet been explored.…”

Section: Introductionmentioning

confidence: 99%

Use of the Modified Early Warning Score in intrahospital transfer of patients

Monzon

Boniatti

2020

Revista Brasileira De Terapia Intensiva

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Objective To verify whether there is an association between the Modified Early Warning Score before the transfer from the emergency room to the ward and death or admission to the intensive care unit within 30 days. Methods This is a historical cohort study conducted in a high-complexity hospital in southern Brazil with patients who were transferred from the emergency room to the ward between January and June 2017. The following data were collected: sociodemographic variables; comorbidities, as determined by the Charlson index; reason for hospitalization; Modified Early Warning Score at the time of transfer; admission to the intensive care unit; care by the Rapid Response Team; mortality within 30 days; and hospital mortality. Results A total of 278 patients were included in the study. Regarding the Modified Early Warning Score, patients who died within 30 days had a significantly higher score than surviving patients during this period (2.0 [1.0 - 3.0] versus 1.0 [1.0 - 2.0], respectively; p = 0.006). The areas under the receiver operating characteristic curve for death within 30 days and for ICU admission were 0.67 (0.55 - 0.80; p = 0.012) and 0.72 (0.59 - 0.84; p = 0.02), respectively, with a Modified Early Warning Score cutoff of ≥ 2. In the Cox regression, the Modified Early Warning Score was independently associated with mortality within 30 days after multivariate adjustment (hazard ratio 2.91; 95% confidence interval 1.04 - 8.13). Conclusion The Modified Early Warning Score before intrahospital transfer from the emergency room to the ward is associated with admission to the intensive care unit and death within 30 days. The Modified Early Warning Score can be an important indicator for monitoring these patients and can prompt the receiving team to take specific actions.

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Performance of patient acuity rating by rapid response team nurses for predicting short-term prognosis

Cited by 4 publications

References 23 publications

Situation awareness in intensive care unit nurses: A qualitative directed content analysis

Situation awareness in intensive care unit nurses: A qualitative directed content analysis

Strategies for successful implementation and permanent maintenance of a rapid response system

Use of the Modified Early Warning Score in intrahospital transfer of patients

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