Strengthening the afferent limb of rapid response systems: an educational intervention using web-based learning for early recognition and responding to deteriorating patients

Abstract

A web-based educational programme developed for hospital nurses to strengthen the afferent limb of the RRS significantly increased their knowledge and performances in assessing, managing and reporting clinical deterioration.

The effect of adult Early Warning Systems education on nurses’ knowledge, confidence and clinical performance: A systematic review

“…(). Six countries were represented across the reviewed studies with the greater numbers conducted in the United States ( n = 3), (Lindsey & Jenkins, ; Ozekcin, Tuite, Willner, & Hravnak, ; Rose, Hanna, Nur, & Johnson, ), Singapore ( n = 2) (Liaw, Chan, Chen, Hooi, & Siau, ; Liaw, Wong, Ang, et al., ; Liaw, Wong, Chan, et al., ), in hospitals ( n = 7) (Cahill et al., ; Kyriacos, Jelsma, James, & Jordan, ; Ludikhuize, De Jonge, & Goossens, ; Merriel et al., ; Ozekcin et al., ; Rose et al., ; Shaddel, Khosla, & Banerjee, ) and simulation settings ( n = 3) (Liaw, Wong, Ang, et al., ; Liaw, Wong, Chan, et al., ; Lindsey & Jenkins, ). Sample size varied between 19 (Shaddel et al., ) and 147 (Cahill et al., ) participants.…”

“…Sample size varied between 19 (Shaddel et al., ) and 147 (Cahill et al., ) participants. Five studies used a pre‐ and post‐test design (Cahill et al., ; Merriel et al., ; Ozekcin et al., ; Rose et al., ; Shaddel et al., ), four studies were RCTs (Kyriacos et al., ; Liaw, Wong, Ang, et al., ; Liaw, Wong, Chan, et al., ; Lindsey & Jenkins, ) and one study was quasi‐experimental (Ludikhuize et al., ). As for the educational interventions used in the reviewed studies, they included the following: interactive programmes, namely Rescuing a Patient in Deteriorating Situations (RAPIDS) (Liaw et al., ) and e‐RAPIDS (Liaw, Wong, Ang, et al., ; Liaw, Wong, Chan, et al., ); fully automated virtual patient simulation and facilitator‐led mannequin‐based simulation (Liaw et al., ); MEWS charts and the Cape Town MEWS training programme and manual (Kyriacos et al., ); educational sessions about a new observation chart (Cahill et al., ); code blue simulation and rapid response education (Lindsey & Jenkins, ); a fictional deteriorating patient (Ludikhuize et al., ); an EWS training session (Merriel et al., ); an e‐learning module and simulation (Ozekcin et al., ); and one‐on‐one and small group education about e‐MEWS (Rose et al., ) and MEWS (Shaddel et al., ).…”

“…The effectiveness of the interventions was assessed using several researcher‐designed instruments, namely a knowledge questionnaire and performance tool (Liaw, Wong, Ang, et al., ; Liaw, Wong, Chan, et al., ); written tests (Kyriacos et al., ); multiple choice questionnaires (Lindsey & Jenkins, ; Ozekcin et al., ); clinical observations (Ludikhuize et al., ); and chart reviews and audits (Merriel et al., ; Rose et al., ).…”

“…Nurses in the reviewed controlled trials were adequately allocated to control and experimental groups, and their allocation was adequately concealed with the exception of one quasi‐experimental study (Ludikhuize et al., ). As for baseline outcome measures, the risk of bias was low in two studies (Kyriacos et al., ; Liaw, Wong, Ang, et al., ; Liaw, Wong, Chan, et al., ) and unclear in the remaining studies (Liaw et al., ; Lindsey & Jenkins, ; Ludikhuize et al., ). Participant characteristics were similar at baseline in all but one RCT (Lindsey & Jenkins, ).…”

“…Knowledge was assessed in four studies (Kyriacos et al., ; Liaw, Wong, Ang, et al., ; Liaw, Wong, Chan, et al., ; Lindsey & Jenkins, ; Ozekcin et al., ). Overall, the knowledge and competence of healthcare professionals improved immediately following various educational programmes.…”