| Título: | Rapid response & rescue: Enhancing the detection and management of the deteriorating patient at St Vincent’s Private Hospital, Sydney |
| Autores: |
Murray, E; St. Vincent’s Private Hospital, Sydney, NSW.
University of Tasmania, Launceston, Tasmania.
Australian Catholic University, Sydney, NSW. Walker, K; St. Vincent’s Private Hospital, Sydney, NSW. University of Tasmania, Launceston, Tasmania. Duff, J; Australian Catholic University, Sydney, NSW. |
| Fecha: | 2013-10-13 |
| Publicador: | Hunter New England Local Health District |
| Fuente: |
Ver documento |
| Tipo: |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
| Tema: | Nursing; Midwifery; Deteriorating Patient; Multidisciplinary Care; Rapid Response Team |
| Descripción: | Problem: Increasingly, we find that our patients have complex co-morbidities which increase their risk of becoming seriously ill during their hospital stay. Warning signs often precede clinical deterioration but evidence suggests that these signs are not always identified, or acted on. Objective: This project used a multidisciplinary collaborative approach to implementing and evaluating an escalation protocol based on best practice and in keeping with the national consensus statement from the Australian Commission on Quality and Safety in Healthcare. Findings: Six months of baseline data revealed that our cardiac arrest rate (4.29 per 1000 inpatient discharges) was similar to rates published in the literature. However, our potentially preventable cardiac arrest rate (0.28 per 1000 inpatient discharges) and our potentially preventable death rate (0.14 per 1000 inpatient discharges) was comparably lower than published reports. The quantitative data corroborated findings from focus groups where participants said that we had a robust, if not formalised, system for the detection and management of the deteriorating patient. Process measures were collected for five weeks following the implementation of the formalised escalation protocol. We found that 85% of audited records had an escalation protocol form and 90% of those were used correctly. Over the five week roll out the percentage of patients with an undocumented trigger reduced from 50% to 15%. We are currently collecting six months of follow-up data on potentially preventable cardiac arrests and deaths. Conclusion: The use of a multidisciplinary collaborative approach to develop an escalation protocol including a rapid response team that is tailored to the local context and incorporates effective current practice with international best-practice enabled the development and successful implementation of a nurse led escalation protocol. References: Gao, H., McDonnell, A., Harrison, D. A, et al. (2007). Systematic review and evaluation of physiological track and trigger warning systems for identifying at-risk patients on the ward. Intensive care medicine,33(4), 667-679. Buist, M., Bernard, S., Nguyen, T. V., Moore, G., & Anderson, J. (2004). Association between clinically abnormal observations and subsequent in-hospital mortality: a prospective study. Resuscitation,62(2),137-141. |
| Idioma: | Inglés |