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Can proactive rapid response team rounding improve surveillance and reduce unplanned escalations in care? A controlled before and after study

Unplanned escalations manifest as a breakdown of hospital care attributable to clinician error through missed or delayed identification of physiological instability, ineffective treatment, or iatrogenic harm. To examine the impact of an Early Warning Score-based proactive rapid response team model o...

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Published in:International journal of nursing studies 2019-03, Vol.91, p.128-133
Main Authors: Danesh, Valerie, Neff, Donna, Jones, Terry L., Aroian, Karen, Unruh, Lynn, Andrews, Diane, Guerrier, Lotricia, Venus, Sam J., Jimenez, Edgar
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cited_by cdi_FETCH-LOGICAL-c396t-5e1d1b27730dd11af831374ef97439ca069e45638ab248699278b055da4dad3b3
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container_title International journal of nursing studies
container_volume 91
creator Danesh, Valerie
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description Unplanned escalations manifest as a breakdown of hospital care attributable to clinician error through missed or delayed identification of physiological instability, ineffective treatment, or iatrogenic harm. To examine the impact of an Early Warning Score-based proactive rapid response team model on the frequency of unplanned intra-hospital escalations in care compared with a rapid response team model based on staff nurse identification of vital sign derangements. Pre- and post Early Warning Score-guided proactive rapid response team model intervention. 237-bed community hospital in the southeastern United States. All hospitalized adults (n = 12,148) during a pre- and post-intervention period. Logistic regressions used to examine the relationship between unplanned ICU transfers and rapid response team models (rapid response team vs. Early Warning Score-guided proactive rapid response team). Unplanned ICU transfers were 1.4 times more likely to occur during the rapid response team baseline period (OR = 1.392, 95% CI [1.017–1.905]) compared with the Early Warning Score-guided proactive rapid response team intervention period. This study reports a difference in the frequency of unplanned escalations using different rapid response models, with fewer unplanned ICU transfers occurring during the use of Early Warning Score-guided proactive rapid response team model while accounting for differences in admission volumes, age, gender and comorbidities. Implementation of this model has implications for patient outcomes, hospital operations and costs.
doi_str_mv 10.1016/j.ijnurstu.2019.01.004
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All hospitalized adults (n = 12,148) during a pre- and post-intervention period. Logistic regressions used to examine the relationship between unplanned ICU transfers and rapid response team models (rapid response team vs. Early Warning Score-guided proactive rapid response team). Unplanned ICU transfers were 1.4 times more likely to occur during the rapid response team baseline period (OR = 1.392, 95% CI [1.017–1.905]) compared with the Early Warning Score-guided proactive rapid response team intervention period. This study reports a difference in the frequency of unplanned escalations using different rapid response models, with fewer unplanned ICU transfers occurring during the use of Early Warning Score-guided proactive rapid response team model while accounting for differences in admission volumes, age, gender and comorbidities. 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source Applied Social Sciences Index & Abstracts (ASSIA); ScienceDirect Freedom Collection 2022-2024
subjects Adolescent
Adult
Aged
Clinical outcomes
Community hospitals
Delayed
Early warning score (EWS)
Emergency medical care
Escalations in care
Female
Florida
Hospital Rapid Response Team
Hospitalization
Humans
Intensive care
Intensive Care Units
Intervention
Male
Middle Aged
Nursing
Nursing Staff, Hospital
Patient assessment
Patient Transfer
Quality improvement
Quality of Health Care
Rapid response team (RRT)
Redesign
Surveillance
Teams
Triage - standards
Unplanned ICU transfers
Young Adult
title Can proactive rapid response team rounding improve surveillance and reduce unplanned escalations in care? A controlled before and after study
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