Translation of evidence into policy to improve clinical practice: the development of an emergency department rapid response system.

Clinical Deterioration Emergency Service, Hospital Humans Policy
Clinical deterioration Emergency service, Hospital Failure to rescue Patient safety Rapid response team Vital signs

Journal

Australasian emergency care
ISSN: 2588-994X
Titre abrégé: Australas Emerg Care
Pays: Australia
ID NLM: 101727782

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 22 07 2020
accepted: 18 08 2020
pubmed: 21 9 2020
medline: 26 10 2021
entrez: 20 9 2020
Statut: ppublish

Résumé

Undetected clinical deterioration is a major cause of high mortality events in Emergency Department (ED) patients. Yet, there is no known model to guide the recognition and response to clinical deterioration in the ED, integrating internal and external resources. An integrative review was firstly conducted to identify the critical components of recognising and responding to clinical deterioration in the ED. Components identified from the review were analysed by clinical experts and informed the development of an ED Clinical Emergency Response System (EDCERS). Twenty four eligible studies were included in the review. Eight core components were identified: 1) vital sign monitoring; 2) track and trigger system; 3) communication plan; 4) response time; 5) emergency nurse response; 6) emergency physician response; 7) critical care team response; and 8) specialty team response. These components informed the development of the EDCERS protocol, integrating responses from staff internal and external to the ED. EDCERS was based on the best available evidence and considered the cultural context of care. Future research is needed to determine the useability and impact of EDCERS on patient and health outcomes.

Sections du résumé

BACKGROUND BACKGROUND
Undetected clinical deterioration is a major cause of high mortality events in Emergency Department (ED) patients. Yet, there is no known model to guide the recognition and response to clinical deterioration in the ED, integrating internal and external resources.
METHODS METHODS
An integrative review was firstly conducted to identify the critical components of recognising and responding to clinical deterioration in the ED. Components identified from the review were analysed by clinical experts and informed the development of an ED Clinical Emergency Response System (EDCERS).
RESULTS RESULTS
Twenty four eligible studies were included in the review. Eight core components were identified: 1) vital sign monitoring; 2) track and trigger system; 3) communication plan; 4) response time; 5) emergency nurse response; 6) emergency physician response; 7) critical care team response; and 8) specialty team response. These components informed the development of the EDCERS protocol, integrating responses from staff internal and external to the ED.
CONCLUSIONS CONCLUSIONS
EDCERS was based on the best available evidence and considered the cultural context of care. Future research is needed to determine the useability and impact of EDCERS on patient and health outcomes.

Identifiants

DOI: 10.1016/j.auec.2020.08.003 PMID: 32950439
pubmed: 32950439
pii: S2588-994X(20)30078-6
doi: 10.1016/j.auec.2020.08.003
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

197-209

Informations de copyright

Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.

Auteurs

Belinda Munroe (B)

Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and Midwifery, Mallet St, Camperdown, NSW, Australia; Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia. Electronic address: belinda.munroe@health.nsw.gov.au.

Kate Curtis (K)

Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and Midwifery, Mallet St, Camperdown, NSW, Australia; Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.

Sharyn Balzer (S)

Emergency Department, Shoalhaven Memorial District Hospital, Shoalhaven, NSW, Australia.

Karlie Royston (K)

Clinical Emergency Response, Executive Services, Shoalhaven Hospital Groups, Shoalhaven, NSW, Australia.

Wendy Fetchet (W)

Emergency Department, Shoalhaven Memorial District Hospital, Shoalhaven, NSW, Australia.

Simon Tucker (S)

Emergency Department, Shoalhaven Memorial District Hospital, Shoalhaven, NSW, Australia.

William Pratt (W)

Department of Medicine, Shoalhaven Memorial District Hospital, Shoalhaven, NSW, Australia.

Richard Morris (R)

Intensive Care Unit, Shoalhaven Memorial District Hospital, Shoalhaven, NSW, Australia; Faculty of Medicine, University of NSW.

Margaret Fry (M)

Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and Midwifery, Mallet St, Camperdown, NSW, Australia; University of Technology Sydney School of Nursing and Midwifery Broadway NSW 2007; Northern Sydney Local Health District.

Julie Considine (J)

School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, and Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia; Centre for Quality and Patient Safety Research - Eastern Health Partnership, Eastern Health, Box Hill, Victoria, Australia.

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Classifications MeSH

questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Évolution de la maladie › Aggravation clinique › Translation of evidence into policy to improve...
questionsmedicales.fr › Administration des services de santé › Organisation et administration › Administration d'établissement de santé › Administration hospitalière › Services hospitaliers › Service hospitalier d'urgences › Translation of evidence into policy to improve...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Translation of evidence into policy to improve...
questionsmedicales.fr › Organisations et économie des soins de santé › Politique (principe) › Translation of evidence into policy to improve...