Objective To analyze and compare the difference of early intervention effect of initiating the rapid response system（RRS）between hospitalized and non-hospitalized patients. Methods The RRS events initiated in a tertiary class A hospital in Zhejiang Province from January 2016 to December 2021 were collected retrospectively. Differences of initiating time,reasons,personnel and patient outcome between hospitalized and non-hospitalized patients were analyzed. Results From 2016 to 2021,983 RRS events were initiated,including 715 inpatients（72.74%）and 268 non-hospitalized patients（27.26%）. The main initiators of RRS were nurses（94.80%）. The res-ponse time of the emergency medical team（MET）after the initiation of RRS was 3（2,4）minutes and 2（1,3）minutes for inpatients and non-hospitalized patients respectively. The visiting departments were surgery（55.81%）and cardiovascular medicine（31.34%）. The main reasons for initiating RRS were sudden loss of consciousness（69.23%）and witnessing patients falling to the ground suddenly（57.84%）. Most required on-site intervention（92.77%）after the initiation of RRS. There was no particularity in the distribution of RRS initiating time periods for inpatients,while the initiating time of RRS for non-hospitalized patients was from 08：00 to 16：00. Conclusion Under homogeneous management,both inpatients and non-hospitalized patients reached MET within 5 minutes after the initiation of RRS. Non-hospitalized patients differed from hospitalized patients in terms of time,place,reasons,and outcome. Attention needs to be paid to the initiation of RRS when the condition of non-hospitalized patients suddenly change in the hospital. It is recommended to carry out RRS-related training and simulation exercises for all personnel in the hospital.
YAN Danping
,
WANG Yuwei
,
WU Zuojia
,
YE Chener
,
WANG Sa
. Retrospective analysis of early intervention effect of initiating rapid response system in hospitalized and non-hospitalized patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023
, 4(1)
: 66
-70
.
DOI: 10.3761/j.issn.2096-7446.2023.01.015
[1] Stevens P,Andrew D,Jane G.Rapid response systems[EB/OL].[2022-08-15].https://www.uptodate.cn/contents/rapid-response-sys-tems.
[2] Churpek MM,Edelson DP,Lee JY,et al.Association between survival and time of day for rapid response team calls in a national registry[J]. Crit Care Med,2017,45(10):1677-1682.
[3] Haegdorens F,van Bogaert P,Roelant E,et al. The introduction of a rapid response system in acute hospitals:a pragmatic stepped wedge cluster randomised controlled trial[J]. Resuscitation,2018,129:127-134.
[4] Teuma Custo R,Trapani J.The impact of rapid response systems on mortality and cardiac arrests- A literature review[J]. Intensive Crit Care Nurs,2020,59:102848.
[5] McGaughey J,Fergusson DA,Van Bogaert P,et al. Early warning systems and rapid response systems for the prevention of patient deterioration on acute adult hospital wards[J]. Cochrane Database Syst Rev,2021,11:CD005529.
[6] de Jong A,Jung B,Daurat A,et al. Effect of rapid response systems on hospital mortality:a systematic review and meta-analysis[J]. Intensive Care Med,2016,42(4):615-617.
[7] Subbe CP,Duller B,Bellomo R.Effect of an automated notification system for deteriorating ward patients on clinical outcomes[J]. Crit Care,2017,21(1):52.
[8] Fletcher GS,Aaronson BA,White AA,et al.Effect of a real-time electronic dashboard on a rapid response system[J]. J Med Syst,2017,42(1):5.
[9] Shappell C,Snyder A,Edelson DP,et al.Predictors of in-hospital mortality after rapid response team calls in a 274 hospital nationwide sample[J]. Crit Care Med,2018,46(7):1041-1048.
[10] 陈水红,闫丹萍,叶文秀,等. 非住院患者快速反应系统的建立与实施[J]. 中华护理杂志,2017,52(10):1204-1206.
Chen SH,Yan DP,Ye WX,et al.Implementation and establishment of rapid response system for non-hospitalized patients[J]. Chin J Nurs,2017,52(10):1204-1206.
[11] Douw G,Schoonhoven L,Holwerda T,et al.Nurses' worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals:a systematic review[J]. Crit Care,2015,19:230.
[12] Rodwin BA,Bilan VP,Merchant NB,et al.Rate of preventable mortality in hospitalized patients:a systematic review and meta-analysis[J]. J Gen Intern Med,2020,35(7):2099-2106.
[13] Odell M.Detection and management of the deteriorating ward patient:an evaluation of nursing practice[J]. J Clin Nurs,2015, 24(1/2):173-182.
