Insight into hospital ward nurses’ concerns about patient health and the corresponding Medical Emergency Team nurse response

• Published in: Intensive & critical care nursing 2019-08, Vol.53, p.100-108
• Main Authors: Kalliokoski, Jaana, Kyngäs, Helvi, Ala-Kokko, Tero, Meriläinen, Merja
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Attitude of Health Personnel; Clinical nursing; Cohort Studies; Collaboration; Concerns; Content analysis; Continuity of Patient Care; Critical care; Critical Care Outreach Team; Early Diagnosis; Emergency medical care; Emergency Medical Services - methods; Emergency Medical Services - standards; Emergency response team calling criteria; Female; Finland; Hospital Rapid Response Team - standards; Hospital Rapid Response Team - statistics & numerical data; Hospitals; Humans; Intensive care; Interprofessional Relations; Male; Medical Emergency Team; Middle Aged; Nurse led services; Nurses; Nursing; Nursing care; Nursing Staff, Hospital - psychology; Nursing Staff, Hospital - statistics & numerical data; Pain; Patient assessment; Patients; Patients' Rooms - organization & administration; Patients' Rooms - statistics & numerical data; Rapid Response Team; Retrospective Studies; Teams; Vital signs; Vital Signs - physiology; Workplace - psychology; Workplace - standards; Worry
• ISSN: 0964-3397; 1532-4036
• DOI: 10.1016/j.iccn.2019.04.009

This study aims to understand the concerns of nurses when making MET calls which did not fulfil the vital sign criteria, and the MET nurses subsequent responses to these calls. This was a retrospective report-based study. Research material included nursing reports and MET forms related to MET calls made due to nurses’ concern. Inductive content analysis was used to identify observations, which were then quantified based on the research material. From a total of 546 MET calls, 39 visits (7%) were due to nurses’ concern. In these 39 visits, the vital sign criteria did not reach the alert threshold, but nurses made the call due to subjective worry. In 13% of visits, the alert concern was inadequate contact with the doctor. MET nurses responded to the alert by providing clinical and indirect nursing; more specifically, they performed examinations and nursing interventions and collaborated with other professionals. A nurse’s worry is influenced by subjective changes in the patient’s condition or an inadequate doctor’s response rather than objective physiological measurements. A MET nurse’s ability to assess patient condition, respond to nurses’ calls, and acknowledge justified alerts help MET nurses support concerned nurses and encourage them to contact the MET if necessary.