The Impact of a Nurse Practitioner Rapid Response Team on Systemic Inflammatory Response Syndrome Outcomes

Benson, Linda M.; Hasenau, Susan M.; OʼConnor, Nancy; Burgermeister, Diane

doi:10.1097/dcc.0000000000000046

Cited by 12 publications

(9 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The balance of covariates after propensity matching confirms that both groups are comparable. All other studies either used a retrospective before and after design, focused on recognition of systemic inflammatory response syndrome, measured post-ICU discharge interventions instead of MET call leadership, did not have ICUR-led MET calls for comparison or measured active surveillance for deteriorating patients rather than MET call leadership [9][10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Comparison of clinical outcomes between nurse practitioner and registrar-led medical emergency teams: a propensity-matched analysis

et al. 2021

View full text Add to dashboard Cite

Objective Medical emergency teams (MET) are mostly led by physicians. Some hospitals are currently using nurse practitioners (NP) to lead MET calls. These are no studies comparing clinical outcomes between these two care models. To determine whether NP-led MET calls are associated with lower risk of acute patient deterioration, when compared to intensive care (ICU) registrar (ICUR)-led MET calls. Methods The composite primary outcome included recurrence of MET call, occurrence of code blue or ICU admission within 24 h. Secondary outcomes were mortality within 24 h of MET call, length of hospital stay, hospital mortality and proportion of patients discharged home. Propensity score matching was used to reduce selection bias from confounding factors between the ICUR and NP group. Results A total of 1343 MET calls were included (1070 NP, 273 ICUR led). On Univariable analysis, the incidence of the primary outcome was higher in ICUR-led MET calls (26.7% vs. 20.6%, p = 0.03). Of the secondary outcome measures, mortality within 24 h (3.4% vs. 7.7%, p = 0.002) and hospital mortality (12.7% vs. 20.5%, p = 0.001) were higher in ICUR-led MET calls. Propensity score-matched analysis of 263 pairs revealed the composite primary outcome was comparable between both groups, but NP-led group was associated with reduced risk of hospital mortality (OR 0.57, 95% CI 0.35–0.91, p = 0.02) and higher likelihood of discharge home (OR 1.55, 95% CI 1.09–2.2, p = 0.015). Conclusion Acute patient deterioration was comparable between ICUR- and NP-led MET calls. NP-led MET calls were associated with lower hospital mortality and higher likelihood of discharge home.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of clinical outcomes between nurse practitioner and registrar-led medical emergency teams: a propensity-matched analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…All studies investigated digital sepsis alerts (Multimedia Appendix 3). Several studies additionally used a rapid response team in combination with the digital sepsis alert in the alerting group [20][21][22]. An electronic order set was used by four studies in the alerting group [21,[23][24][25].…”

Section: Characteristics Of Studies and Digital Alerting Usedmentioning

confidence: 99%

“…Most studies were based in the United States; however, one study was from the Kingdom of Saudi Arabia [20] and one was from Spain [27]. Most studies were based in large hospital settings; six studies were based in academic centers [20,22,23,[28][29][30], and three centers were level 1 trauma centers [21,29,31]. Within the hospital setting, only one study had a hospital-wide sepsis alert [21], and eight had alerts solely in the emergency department (ED) [20,23,27,[29][30][31][32][33].…”

Section: Characteristics Of Studies and Digital Alerting Usedmentioning

confidence: 99%

“…Within the hospital setting, only one study had a hospital-wide sepsis alert [21], and eight had alerts solely in the emergency department (ED) [20,23,27,[29][30][31][32][33]. In addition, five studies included only medical wards [24,26,28,34,35], and two studies included both on medical and surgical wards [22,25]. All the studies were pre-and postimplementation studies.…”

Section: Characteristics Of Studies and Digital Alerting Usedmentioning

confidence: 99%

“…The type of electronic alerts used in the studies varied. Most studies used digital alerts generated through EHRs on desktop-based computers [20][21][22][23]27,[29][30][31][32][33][34][35]. Two studies involved alerting via a mobile device [24,25] and two studies used text paging [26,28].…”

Section: Characteristics Of Studies and Digital Alerting Usedmentioning

confidence: 99%

See 2 more Smart Citations

Digital Alerting and Outcomes in Patients With Sepsis: Systematic Review and Meta-Analysis

et al. 2019

View full text Add to dashboard Cite

Background The diagnosis and management of sepsis remain a global health care challenge. Digital technologies have the potential to improve sepsis care. Objective The aim of this paper was to systematically review the evidence on the impact of digital alerting systems on sepsis related outcomes. Methods The following databases were searched for studies published from April 1964 to February 12, 2019, with no language restriction: EMBASE, MEDLINE, HMIC, PsycINFO, and Cochrane. All full-text reports of studies identified as potentially eligible after title and abstract reviews were obtained for further review. The search was limited to adult inpatients. Relevant articles were hand searched for other studies. Only studies with clear pre- and postalerting phases were included. Primary outcomes were hospital length of stay (LOS) and intensive care LOS, whereas secondary outcomes were time to antibiotics and mortality. Studies based solely on intensive care, case reports, narrative reviews, editorials, and commentaries were excluded. All other trial designs were included. A qualitative assessment and meta-analysis were performed. Results This review identified 72 full-text articles. From these, 16 studies met the inclusion criteria and were included in the final analysis. Of these, 8 studies reviewed hospital LOS, 12 reviewed mortality outcomes, 5 studies explored time to antibiotics, and 5 studies investigated intensive care unit (ICU) LOS. Both quantitative and qualitative assessments of the studies were performed. There was evidence of a significant benefit of digital alerting in hospital LOS, which reduced by 1.31 days (P=.014), and ICU LOS, which reduced by 0.766 days (P=.007). There was no significant association between digital alerts and mortality (mean decrease 11.4%; P=.77) or time to antibiotics (mean decrease 126 min; P=.13). Conclusions This review highlights that digital alerts can considerably reduce hospital and ICU stay for patients with sepsis. Further studies including randomized controlled trials are necessary to confirm these findings and identify the choice of alerting system according to the patient status and pathological cohort.

show abstract

Understanding how medications contribute to clinical deterioration and are used in rapid response systems: A comprehensive scoping review

Levkovich

Bingham

Jones

et al. 2019

Australian Critical Care

View full text Add to dashboard Cite

The Impact of a Nurse Practitioner Rapid Response Team on Systemic Inflammatory Response Syndrome Outcomes

Cited by 12 publications

References 22 publications

Comparison of clinical outcomes between nurse practitioner and registrar-led medical emergency teams: a propensity-matched analysis

Comparison of clinical outcomes between nurse practitioner and registrar-led medical emergency teams: a propensity-matched analysis

Digital Alerting and Outcomes in Patients With Sepsis: Systematic Review and Meta-Analysis

Understanding how medications contribute to clinical deterioration and are used in rapid response systems: A comprehensive scoping review

Contact Info

Product

Resources

About