Factors Influencing Registered Nurses’ Decision to Activate an Adult Rapid Response Team in a Community Hospital

Jackson, Shirley; Penprase, Barbara; Grobbel, Claudia

doi:10.1097/dcc.0000000000000162

Cited by 26 publications

(40 citation statements)

References 43 publications

(85 reference statements)

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“…This was achieved by making the most of the numerical scoring classification. In doing so, the nurses were adhering to local policies; whilst on the other hand relinquishing their immediate responsibility to another healthcare professional, (Kyriacos 2011, Martin 2012, and Jackson & Penprase 2016 Remarkably, none of n=10 participants offered any explanation for the elevation of the physiological parameters. These parameters were essentially used as a landmark to connect the numerical score to the specific vital signs.…”

Section: Discussionmentioning

confidence: 99%

“…Utilising, the Modified Early Warning Score as a tool to escalate concerns commonly referred to as the acronym (MEWS). The correct utility of the T&T system plus a basic understanding and interpretation of the physiological changes is needed to activate this process, (Considine et al 2015, Fasolino & Verdin 2015Smith & Aitken 2015, Jackson & Penprase 2016.…”

Section: Initiatives To Improve the Care Of The Deteriorating Patientmentioning

confidence: 99%

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Factors that influence nurses' assessment of patient acuity and response to acute deterioration

et al. 2018

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Factors that influence nurses' assessment of patient acuity and response to acute deterioration.http://researchonline.ljmu.ac.uk/8425/ Article LJMU has developed LJMU Research Online for users to access the research output of the University more effectively. Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Users may download and/or print one copy of any article(s) in LJMU Research Online to facilitate their private study or for non-commercial research. You may not engage in further distribution of the material or use it for any profit-making activities or any commercial gain.The version presented here may differ from the published version or from the version of the record. Please see the repository URL above for details on accessing the published version and note that access may require a subscription. As they are responsible for the care they provide to their patients. A part of this care is the monitoring of the patient's vital signs such as blood pressure, pulse, respiratory rate, temperature, which are fundamental in the surveillance of health deterioration.

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Section: Discussionmentioning

confidence: 99%

Section: Initiatives To Improve the Care Of The Deteriorating Patientmentioning

confidence: 99%

Factors that influence nurses' assessment of patient acuity and response to acute deterioration

et al. 2018

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“…These reviews could consider standardising decision-making processes including the transfer of consumers post an APD event, particularly in terms of parameter-setting surrounding medical clearance and level of medical deterioration that can be managed in a mental health unit. While nurses in our study felt that there were unrealistic expectations about the level of medical morbidity they were expected to cope with, it may be that a more constructive response might be to improve their skills and confidence to deal with these complexities rather than relying on protocols of ev- Jackson, Penprase, & Grobbel, 2016;Reardon, Fernando, Murphy, Rosenberg, & Kyeremanteng, 2018;Wilson et al, 2017;Yun et al, 2018).…”

Section: Discussionmentioning

confidence: 84%

Clarity, confidence and complexity: Learning from mental health nurses' experiences of events involving physiological deterioration of consumers in acute inpatient mental health settings

Brunero

Everett

Ramjan

et al. 2020

Journal of Clinical Nursing

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Aims and objective To capture the experiences of nurses in relation to the acutely physiologically deteriorating consumer. Background Improving the physical health care of consumers with mental illness has been widely adopted as a priority for mental health nursing. Much of the effort thus far has focused on routine screening, prevention and treatment of common comorbidities including cardiovascular disease, diabetes mellitus and cancer. There has been less focus on the acutely physiologically deteriorating consumer in the mental health setting. Further study is warranted since this issue poses a set of highly complex challenges for nurses within the inpatient setting. Method An exploratory, descriptive study was employed using focus groups to gather narrative data, which was then subject to qualitative analysis. Eleven mental health inpatient wards within a local health district in Sydney, Australia, were studied, comprising ward‐based nurses (n = 64) and nurse unit managers (n = 8). This paper follows the COREQ guidelines for reporting qualitative health research. Results Qualitative data analysis revealed three themes central to the nurses' experience: (a) lack of clarity (subthemes: procedures and leadership accountability); (b) confidence in the workforce (subthemes: knowledge and skills, training needs, relevant experience, collaboration with emergency and medical teams, stigmatising attitudes); and (c) complexity (subthemes: complexity as the new norm and suitability of the mental health environment). Conclusion The themes found in this study can be used to guide and inform healthcare policy, protocols, education and processes around building a more confident nurse workforce for the acutely physiologically deteriorating consumer. Relevance to clinical practice Findings provide a rich data set for the generation of measurement tools and protocols to guide physical health care and evaluate performance.

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“…7 To improve communication, Bailey and colleagues 8 added an EWS alert to the medical-surgical charge nurse's pager but could not explain a lack of improvement in patients' outcomes, suggesting that a more integrated approach to identify interventions is needed. Jackson and others 9 reported a strong negative correlation between medical-surgical nurses' years of experience and reluctance to activate an RRT call. They concluded that "collaborative support from seasoned colleagues" targeting inexperienced medical-surgical nurses could improve outcomes of patients whose condition is deteriorating.…”

Section: Introductionmentioning

confidence: 97%

“…They concluded that "collaborative support from seasoned colleagues" targeting inexperienced medical-surgical nurses could improve outcomes of patients whose condition is deteriorating. 9 Experienced ICU nurses serving on RRTs are trained to recognize and intervene in situations of clinical deterioration. We hypothesized that an EWS communication bundle including an experienced ICU nurse would decrease transfers, RRT calls, and morbidity of medical-surgical patients transferred to the ICU.…”

Section: Introductionmentioning

confidence: 99%

Early Warning Score Communication Bundle: A Pilot Study

Gagne

Fetzer

2018

American Journal of Critical Care

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Background Unplanned admissions of patients to intensive care units from medical-surgical units often result from failure to recognize clinical deterioration. The early warning score is a clinical decision support tool for nurse surveillance but must be communicated to nurses and implemented appropriately. A communication process including collaboration with experienced intensive care unit nurses may reduce unplanned transfers. Objective To determine the impact of an early warning score communication bundle on medical-surgical transfers to the intensive care unit, rapid response team calls, and morbidity of patients upon intensive care unit transfer. Methods After an early warning score was electronically embedded into medical records, a communication bundle including notification of and telephone collaboration between medical-surgical and intensive care unit nurses was implemented. Data were collected 3 months before and 21 months after implementation. Results Rapid response team calls increased nonsignificantly during the study period (from 6.47 to 8.29 per 1000 patient-days). Rapid response team calls for patients with early warning scores greater than 4 declined (from 2.04 to 1.77 per 1000 patient-days). Intensive care unit admissions of patients after rapid response team calls significantly declined (P = .03), as did admissions of patients with early warning scores greater than 4 (P = .01), suggesting that earlier intervention for patient deterioration occurred. Documented reassessment response time declined significantly to 28 minutes (P = .002). Conclusion Electronic surveillance and collaboration with experienced intensive care unit nurses may improve care, control costs, and save lives. Critical care nurses have a role in coaching and guiding less experienced nurses.

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Factors Influencing Registered Nurses’ Decision to Activate an Adult Rapid Response Team in a Community Hospital

Cited by 26 publications

References 43 publications

Factors that influence nurses' assessment of patient acuity and response to acute deterioration

Factors that influence nurses' assessment of patient acuity and response to acute deterioration

Clarity, confidence and complexity: Learning from mental health nurses' experiences of events involving physiological deterioration of consumers in acute inpatient mental health settings

Early Warning Score Communication Bundle: A Pilot Study

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