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Overview of Obstetric Emergencies
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Sanjeewa Padumadasa, Malik Goonewardene
Early activation of a rapid response team, which comprises a diverse range of clinicians and stakeholders, has been associated with a decrease in the incidence of maternal cardiac arrest and admission to intensive care units, as well as an improvement in the survival rate of hospitalised patients. In addition to the routine critical care team, there should be a practitioner who is competent in performing delivery and a practitioner who is competent in the resuscitation of the neonate. If the transfer of a critically ill pregnant woman to a specialised centre is deemed necessary, then arranging facilities for delivery of the fetus if needed during transit, is an important aspect of management of an emergency.
Clinical Workflows Supported by Patient Care Device Data
Published in John R. Zaleski, Clinical Surveillance, 2020
Responding to adverse patient events has given rise to a collaborative clinical team that is focused on preventing further deterioration in patients in whom emergent conditions such as sepsis have arisen. The concept of the Rapid Response Team (RRT) was introduced in hospitals throughout the United States and Europe as a means of intervening in patient decline and decompensation prior to the onset of a mortal adverse event for which there is a risk associated with failure to rescue (FTR).* Key measures for the early onset warnings that trigger the deployment of such teams include changes in vital signs that may herald the onset of possibly irreversible cardiac, neurologic, or respiratory deterioration in patients, resulting in the potential for “failure to rescue” in the case of adverse events.
Avoiding hospital admission
Published in Anita Sharma, David Pitchforth, Gail Richards, Joyce Barclay, COPD in Primary Care, 2018
Anita Sharma, David Pitchforth, Gail Richards, Joyce Barclay
As a result, a new service model was developed, referred to as intermediate care, which includes the following: a rapid response team in the community or in the Accident and Emergency departmentan early discharge schemeshort-term rehabilitation within residential care or the patient’s own homehospital at homecommunity matron input on a regular basis.
The Role of Canadian respiratory therapists in adult critical care (ICURT-CAN): A scoping review
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2023
Shirley Quach, Marco Zaccagnini, Tara L. Packham, Roger Goldstein, Dina Brooks
RTs were commonly included in extended critical care teams, either as part of the rapid response or tracheostomy care team. The rapid response team, synonymous to the medical emergency team or critical care outreach, was described as a team of interdisciplinary clinicians with critical care experience to respond to critically ill and deteriorating patients in the hospital, outside of the ICU.87 The rapid response team model was introduced in the late 2000s at the First consensus meeting on Medical Emergency Teams,87 and endorsed by the Canadian Patient Safety Institute in 2009, who recommended including RTs as part of the team.76 This may explain the interest in evaluating the RT role in the rapid response team in various quality improvement projects published between 2008 to 2018.51,52,54,55 Although these studies did not explicitly evaluate RTs’ impact on patient outcomes, collaborative implementation of these interprofessional teams showed benefits.51,55 For example, the extended critical care team (consisted of critical care nurse, RT and intensivist) at the Ottawa Hospital showed improved patient severity scores, decreased cardiac arrests and ICU admissions (all p < 0.01).51 Similarly, in a continuous quality improvement project in four regional hospitals of Interior Health, British Columbia, the High Acuity Response team (HART) included RTs for transports, saving staffing resources in community hospitals.54 For studies evaluating tracheostomy teams with integrated RT members, these teams were shown to decrease the time to SLP referral, first tracheostomy tube change, increased use of speaking valves and reduced complication rates.27,29
A study on the factors that influence the agility of COVID-19 hospitals
Published in International Journal of Healthcare Management, 2021
M. Suresh, A. Roobaswathiny, S. Lakshmi Priyadarsini
Building a Rapid Response Team (RRT)/medical emergency team is a process of developing a team with specialist physicians who can provide critical care to the hospitalized Covid patients in intensive care and non-intensive care units. RRT provides specialized trainings for caregivers to respond to the calls from the general care units, and to assess and manage patients whose condition is oscillating before they reach a full code level [2].
The rapid response system: an integrative review
Published in Contemporary Nurse, 2019
John Rihari-Thomas, Michelle DiGiacomo, Phillip Newton, David Sibbritt, Patricia M. Davidson
Hospital cultures are complex, multifaceted and highly individualised. The degree of success or failure of RRS depends very much on a facilities adaptability and acceptance to change. It is not enough to simply introduce a rapid response system and expect it to work effectively and with full compliance. Van Der Weyden (2009) researched the attitudes of Australian clinicians to system change. Results showed that clinicians generally do value the implementation & use of evidence based systems for client centred care within the context of the Australian health care setting. Looking more closely at cultural attitudes and behaviours within RRS, Salamonson and colleagues (Salamonson et al., 2006) identified nurse years of experience as a major factor in system activation. Experienced nurses believed the greatest benefits were getting immediate help or attention, followed by their use in early recognition and management of deterioration. Rapid response also provided a backup system if they were worried about a patient, or were not satisfied with a current medical management plan. From 2004 to 2006, the Robert Wood Johnson Foundation funded demonstration projects in nine geographic locations to support RRS (Foote, 2010). Focus group evaluation with key groups at one ‘robust’ and one ‘late adopter’ hospital in this evaluation provided important information about the characteristics of rapid response teams, and a view of these teams ‘through the eyes of a nurse’. Their work provided new insight into what makes a rapid response team successful and underscores the importance of considering process issues as well as outcome issues in health system redesign. In ‘robust’ adopter centres where the teams were an accepted part of hospital system culture, nurses were confident they had a positive effect, and were activated without hesitation. The opposite seemed to be prevalent in more ‘challenged centres’, with nurses hesitant and more inclined to exhaust all other avenues before reluctantly activating a rapid response. Nurses were also worried about the attitude and level of assistance they would receive from rapid response team members on arrival in these later centres. Cultural leaders also played a part in the success of these teams in robust hospitals with both clear leadership and a ‘no option’ attitude to activation.