A Patient Safety Solution: Evaluation of a 24/7 Nurse-led Proactive Rapid Response Program

International Journal of Critical Care and Emergency Medicine Pub Date : 2022-09-20 DOI:10.29173/ijcc32

Fiona A. Winterbottom, Heather Webre, Kala Gaudet, Jeff Burton

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Abstract

Background: Rapid Response Systems are patient safety programs that have been implemented around the world to reduce preventable patient harm and failure to rescue. Problem: There was a high rate of cardiac arrests outside the intensive care unit and absence of a structured system to identify and rescue patients with signs of clinical deterioration prior to cardiac arrest. Objectives: To evaluate the impact of a structured 24/7 nurse-led proactive rapid response program on clinical deterioration and cardio-pulmonary arrests. Methods: This study took place in a 650-bed quaternary academic regional referral center. The study period was between January 2014 and February 2020. A rapid response system redesign was initiated in early 2017 and a 24/7 nurse-led proactive rapid response program launched in December 2017. Results: A statistically significant decrease in rates of critical care cardio-pulmonary arrests, non-critical care cardio-pulmonary arrests, rapid response consults, unplanned ICU transfers, and hospital deaths occurred following implementation of the 24/7 nurse-led proactive rapid response program. Conclusions: Implementation of a structured 24/7 nurse-led rapid response program can decrease cardio-pulmonary arrests, unplanned transfers to ICU, and hospital deaths.

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患者安全解决方案:24/7护士主导的主动快速反应计划的评估

背景:快速反应系统是在世界各地实施的患者安全规划，旨在减少可预防的患者伤害和抢救失败。问题:在重症监护病房外心脏骤停的发生率很高，并且缺乏一个结构化的系统来识别和抢救在心脏骤停之前有临床恶化迹象的患者。目的:评估一个结构化的24/7护士主导的主动快速反应程序对临床恶化和心肺骤停的影响。方法:本研究在一个有650个床位的第四纪学术区域转诊中心进行。研究期间为2014年1月至2020年2月。2017年初启动了对快速反应系统的重新设计，并于2017年12月启动了由护士领导的24/7主动快速反应计划。结果:在实施24/7护士主导的主动快速反应方案后，重症监护心肺骤停、非重症监护心肺骤停、快速反应咨询、计划外ICU转移和医院死亡的发生率有统计学意义上的显著下降。结论:实施结构化的24/7护士主导的快速反应方案可以减少心肺骤停、计划外转移到ICU和医院死亡。

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International Journal of Critical Care and Emergency Medicine

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