Nursing and Medical Perceptions of a Hospital Rapid Response System

Douglas, Clint; Osborne, Sonya; Windsor, Carol; Fox, Robyn; Booker, Catriona; Jones, Lee; Gardner, Glenn

doi:10.1097/ncq.0000000000000139

Cited by 38 publications

(82 citation statements)

References 21 publications

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“…Clinicians who work together as a team to achieve specific goals have specialised work roles involving task‐specific competencies; they share resources and communicate to collaborate and adapt to change . However, individual clinicians bring with them various attitudes, knowledge, skills and levels of experience, including societal perceptions of group hierarchy that impact on decision‐making . There is evidence that NTS teamwork training is necessary to enhance clinicians' understanding of roles, to improve communication practices, and to enable shared decision‐making among team members .…”

Section: Introductionmentioning

confidence: 99%

Improving the non‐technical skills of hospital medical emergency teams: The Team Emergency Assessment Measure (TEAM™)

Cant

Porter

Cooper

et al. 2016

Emerg Medicine Australasia

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Section: Introductionmentioning

confidence: 99%

Improving the non‐technical skills of hospital medical emergency teams: The Team Emergency Assessment Measure (TEAM™)

Cant

Porter

Cooper

et al. 2016

Emerg Medicine Australasia

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“…A report by Cretikos et al () highlighted RR as the neglected vital sign and in spite of improvements in care such as EWS, failure to assess RR is still commonplace. Conversely, more recent studies have established that nurses are aware of the significance of RR (Douglas, Osborne, et al, ; McDonnell et al, ). Measurement of RR is classed as a simple, cost effective and probably the most important vital sign (Kellett & Sebat, ), yet also often called the vexatious vital sign, as time, skill and patience are required (Kellett & Sebat, ; Lovett, Buchwald, Stürmann, & Bijur, ).…”

Section: Discussionmentioning

confidence: 99%

“…Professional relationships between nurses and doctors have long been seen as problematic (Chalwin, Flabouris, Kapitola, & Dewick, ; Chua et al, ; Douglas, Osborne, et al, ; Kitto et al, ; Massey, Chaboyer, & Aiken, ). A qualitative study identified that the perceived hierarchy between the medicine and nursing professional may halter escalation of care (Chua et al, ).…”

Section: Discussionmentioning

confidence: 99%

To identify the factors that influence the recognizing and responding to adult patient deterioration in acute hospitals

Treacy

Stayt

2019

Journal of Advanced Nursing

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Aims To identify factors that influence recognition and response to adult patient deterioration in acute hospitals. Design A mixed‐studies systematic review. Data Sources CINAHL, Medline, and Web of Science were searched for relevant literature published between 2007 – 2018. Review Methods Studies were critically appraised, data extracted and thematically analysed. Results Thirteen papers met the inclusion criteria. Three main themes were identified: (a) Knowledge and understanding of clinical deterioration; (b) Organizational factors; managing deterioration and staffing levels; and (c) Communication; inter‐professional relationships and professional‐patient communication. Conclusion Despite national guidelines, the review findings suggest that the recognition and response to adult patient deterioration in acute hospital settings is sub‐optimal. A multitude of factors influencing the recognition and response to adult patient deterioration emerged from the findings. Impact Patients are receiving sub‐optimal care due to failure in recognizing and responding to patient deterioration in an appropriate and timely manner. Nurses lack knowledge and understanding of deterioration. Organizational factors contribute to inadequate care and communication among professionals was highlighted as challenging. The factors that influence the recognizing and responding to patient deterioration in acute hospitals are multi‐faceted, however this review highlights immediate recommendations for professionals in the acute care setting.

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“…, Douglas et al . ) are also likely to influence successful adoption in practice (Hills , Douglas et al . ), as reflected in our findings.…”

Section: Discussionmentioning

confidence: 99%

User acceptance of observation and response charts with a track and trigger system: a multisite staff survey

Elliott

Allen

McKinley

et al. 2016

Journal of Clinical Nursing

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Aims and objectives. To examine user acceptance with a new format of charts for recording observations and as a prompt for responding to episodes of clinical deterioration in adult medical-surgical patients. Background. Improving recognition and response to clinical deterioration remains a challenge for acute healthcare institutions globally. Five chart templates were developed in Australia, combining human factors design principles with a track and trigger system for escalation of care. Two chart templates were previously tested in simulations, but none had been evaluated in clinical practice. Design. Prospective multisite survey of user acceptance of the charts in practice. Methods. New observation and response charts were trialled in parallel with existing charts for 24 hours across 36 adult acute medical-surgical wards, covering 108 shifts, in five Australian states. Surveys were completed by 477 staff respondents, with open-ended comments and narrative from short informal feedback groups providing elaboration and context of user experiences. Results. Respondents were broadly supportive of the chart format and content for monitoring patients, and as a prompt for escalating care. Some concerns were noted for chart size and style, use of ranges to graph vital signs and with specific human factors design features. Information and training issues were identified to improve usability and adherence to chart guidelines and to support improved detection and response for patients with clinical deterioration.Conclusions. This initial evaluation demonstrated that the charts were perceived as appropriate for documenting observations and as a prompt to detect clinical deterioration. Further evaluation after some minor modifications to the chart is recommended.What does this paper contribute to the wider global clinical community?• Implementing practice initiatives to improve recognition and response to clinical deterioration (the afferent limb of the rapid response system) remains a global healthcare challenge This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. Relevance to clinical practice. Explicit training on the principles and rationale of human factors chart design, use of embedded change management strategies and addressing practical issues will improve authentic engagement, staff acceptance and adoption by all clinical users when implementing a similar observation and response chart into practice.

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Nursing and Medical Perceptions of a Hospital Rapid Response System

Cited by 38 publications

References 21 publications

Improving the non‐technical skills of hospital medical emergency teams: The Team Emergency Assessment Measure (TEAM™)

Improving the non‐technical skills of hospital medical emergency teams: The Team Emergency Assessment Measure (TEAM™)

To identify the factors that influence the recognizing and responding to adult patient deterioration in acute hospitals

User acceptance of observation and response charts with a track and trigger system: a multisite staff survey

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