Objective To explore the influencing factors and countermeasures of delayed rapid response team (RRT)activation in the Department of Neurosurgery. Methods We retrospectively analyzed the data of hospitalized patients treated with RRT from the Department of Neurosurgery in a tertiary class A hospital in Hangzhou,Zhejiang Province from January 2019 to June 2022. The patients were divided into two groups(delayed and non-delayed)according to whether the call duration was longer than 15 minutes. We compared the differences in clinical indicators between the two groups and analyzed influencing factors of delayed RRT activation. Results A total of 86 patients(59.3%)were found to experience delayed RRT activation among 145 included patients. Logistic regres-sion analysis showed that aged 65 and over,having more than two comorbidities,a score of GCS less than 9,and night duty(17:01—07:59)were independent risk factors for delayed RRT activation(P<0.05). A score of MEWS(Modified Early Warning Score)more than 7 was an independent protective factor(P<0.05). Conclusion Nurses should pay attention to aged or critically ill patients,patients with multiple comorbidities or nursed during night duty and ensure the continuity of care. It is suggested to establish a specialized early warning system for neurosurgery patients. The hospitals should strengthen monitoring and data analysis and provide training for nurses through diversified ways to help them summon the rapid response system effectively.
QIAN Ping
,
ZHANG Qiuxia
,
Pan Yanhong
,
ZHANG Ling
,
PAN Shengdong
,
XU Jinfang
. Influencing factors and countermeasures of delayed rapid response team activation in Neurosurgery Department[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023
, 4(3)
: 258
-262
.
DOI: 10.3761/j.issn.2096-7446.2023.03.014
[1] Buist M,Bernard S,Nguyen TV,et al.Association between clinically abnormal observations and subsequent in-hospital mortality:a prospective study[J]. Resuscitation,2004,62(2):137-141.
[2] 窦丽稳,高伟波,朱继红. 快速反应小组的研究进展[J]. 中华急诊医学杂志,2018,27(5):570-573.
Dou LW,Gao WB,Zhu JH.Advances in rapid response teams[J]. Chin J Emerg Med,2018,27(5):570-573.
[3] 庄一渝,周艳,周丽萍,等. 快速反应系统对住院危重患者抢救成功率的影响[J]. 中华护理杂志,2014,49(5):569-573.
Zhuang YY,Zhou Y,Zhou LP,et al.Effect of rapid response system on the successful rescue rate of critically ill patients[J]. Chin J Nurs,2014,49(5):569-573.
[4] Gupta S,Green C,Subramaniam A,et al.The impact of delayed rapid response call activation on patient outcomes[J]. J Crit Care,2017,41:86-90.
[5] Reardon PM,Fernando SM,Murphy K,et al.Factors associated with delayed rapid response team activation[J]. J Crit Care,2018,46:73-78.
[6] Boniatti MM,Azzolini N,Viana MV,et al.Delayed medical emergency team calls and associated outcomes[J]. Crit Care Med,2014,42(1):26-30.
[7] Chen J,Bellomo R,Flabouris A,et al.Delayed emergency team calls and associated hospital mortality:a multicenter study[J]. Crit Care Med,2015,43(10):2059-2065.
[8] 徐莉,潘胜东,夏萍,等. 大型公立综合医院实施快速反应小组的效果评价[J]. 中华急诊医学杂志,2021,30(11):1390-1393.
Xu L,Pan SD,Xia P,et al.Effect evaluation of rapid response team implementation in a large public general hospital[J]. Chin J Emerg Med,2021,30(11):1390-1393
[9] 杭莺,费甄甄,唐静,等. 快速反应小组的启动标准及护士面临的挑战[J]. 护士进修杂志,2018,33(23):2145-2149.
Hang Y,Fei ZZ,Tang J,et al.Initiation criteria for rapid response teams and challenges faced by nurses[J]. J Nurs Train, 2018,33(23):2145-2149.
[10] Reardon PM,Fernando SM,Murphy K,et al.Factors associated with delayed rapid response team activation[J]. J Crit Care,2018,46:73-78.
[11] 胡潇云,吕鑫,王勰,等. 536例开颅手术患者手术部位感染影响因素的Logistic回归分析[J]. 中华医院感染学杂志,2019,29(8):1176-1180.
Hu XY,Lü X,Wang X,et al.Logistic regression analysis of risk factors for surgical site in 536 cases of craniotomy[J]. Chin J Nosocomiol,2019,29(8):1176-1180.