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- Title
- Rapid Response Teams versus Critical Care Outreach Teams: Unplanned Escalations in Care and Associated Outcomes.
- Creator
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Danesh, Valerie, Neff, Donna, Aroian, Karen, Andrews, Diane, Unruh, Lynn, University of Central Florida
- Abstract / Description
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The incidence of unplanned escalations during hospitalization is undocumented, but estimates may be as high as 1.2 million occurrences per year in the United States. Rapid Response Teams (RRT) were developed for the early recognition and treatment of deteriorating patients to deliver time-sensitive interventions, but evidence related to optimal activation criteria and structure is limited. The purpose of this study is to determine if an Early Warning Score-based Critical Care Outreach (CCO)...
Show moreThe incidence of unplanned escalations during hospitalization is undocumented, but estimates may be as high as 1.2 million occurrences per year in the United States. Rapid Response Teams (RRT) were developed for the early recognition and treatment of deteriorating patients to deliver time-sensitive interventions, but evidence related to optimal activation criteria and structure is limited. The purpose of this study is to determine if an Early Warning Score-based Critical Care Outreach (CCO) model is related to the frequency of unplanned intra-hospital escalations in care compared to a RRT system based on staff nurse identification of vital sign derangements and physical assessments. The RRT model, in which staff nurses identified vital sign derangements to active the system, was compared with the addition of a CCO model, in which rapid response nurses activated the system based on Early Warning Score line graphs of patient condition over time. Logistic regressions were used to examine retrospective data from administrative datasets at a 237-bed community non-teaching hospital during two periods: 1) baseline period, RRT model (n=5,875) (Phase 1: October 1, 2010 (-) March 31, 2011), and; 2) intervention period, RRT/CCO model (n=6,273). (Phase 2: October 1, 2011 (-) March 31, 2012). The strongest predictor of unplanned escalations to the Intensive Care Unit was the type of rapid response system model. Unplanned ICU transfers were 1.4 times more likely to occur during the Phase 1 RRT period. In contrast, the type of rapid response model was not a significant predictor when all unplanned escalations (any type) were grouped together (medical-surgical-to-intermediate, medical-surgical-to-ICU and intermediate-to-ICU). This is the first study to report a relationship between unplanned escalations and different rapid response models. Based on the findings of fewer unplanned ICU transfers in the setting of a CCO model, health services researchers and clinicians should consider using automated Early Warning score graphs for hospital-wide surveillance of patient condition as a safety strategy.
Show less - Date Issued
- 2015
- Identifier
- CFE0006212, ucf:51093
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0006212
- Title
- APPRECIATING THE GOLDEN HOUR: A COMPARATIVE INTERDISCIPLINARY STUDY.
- Creator
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Tachon, Taylor, Heglund, Stephen, Covelli, Maureen, University of Central Florida
- Abstract / Description
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Within the health care, many medical professionals know about the critical time restraints for provisions of care within their discipline, but do not know the term "The Golden Hour". The Golden Hour is a term indicating the universal time restraint found within every area of health care and more specifically, every area of nursing. The term and concept represented by it should be recognized to better the outcomes of our patients. Although the Golden Hour typically indicates a 60-minute period...
Show moreWithin the health care, many medical professionals know about the critical time restraints for provisions of care within their discipline, but do not know the term "The Golden Hour". The Golden Hour is a term indicating the universal time restraint found within every area of health care and more specifically, every area of nursing. The term and concept represented by it should be recognized to better the outcomes of our patients. Although the Golden Hour typically indicates a 60-minute period of time, various settings recognize shorter and longer periods during which specific actions must be taken to assure positive patient outcomes. To meet this aim, this thesis will review studies related to outcomes as associated with time critical interventions that could be categorized by "The Golden Hour". To meet the goal, a search of CINAHL, MEDLINE, PsychINFO, and ScienceDirect databases was conducted. Findings of the search revealed that while the term is not widely used, the concept of time sensitive care is found in many areas of Health Care and, specifically, within multiple sub-disciplines of nursing.
Show less - Date Issued
- 2018
- Identifier
- CFH2000314, ucf:45846
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH2000314
