The effect of a staged, emergency department specific rapid response system on reporting of clinical deterioration

Considine, Julie, Rawet, Jen and Currey, Judy 2015, The effect of a staged, emergency department specific rapid response system on reporting of clinical deterioration, Australasian emergency nursing journal, vol. 18, no. 4, pp. 218-226, doi: 10.1016/j.aenj.2015.07.001.

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Title The effect of a staged, emergency department specific rapid response system on reporting of clinical deterioration
Author(s) Considine, JulieORCID iD for Considine, Julie
Rawet, JenORCID iD for Rawet, Jen
Currey, JudyORCID iD for Currey, Judy
Journal name Australasian emergency nursing journal
Volume number 18
Issue number 4
Start page 218
End page 226
Total pages 9
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2015-11
ISSN 1574-6267
Keyword(s) Emergency medicine
Emergency nursing
Patient safety
Rapid response teams
Risk management
Summary BACKGROUND: Despite emerging evidence regarding clinical deterioration in emergency department (ED) patients, the widespread uptake of rapid response systems (RRS) in EDs has been limited. AIMS: To evaluate the effect of an ED RRS on reporting of clinical deterioration and determine if there were differences between patients who did, and did not, deteriorate during ED care. METHODS: A retrospective cross sectional design was used to conduct this single site study in Melbourne, Australia. Stratified random sampling identified 50 patients with shortness of breath, chest pain or abdominal pain per each year studied (2009-2012) giving a total of 600 patients. The intervention was an ED RRS implemented in stages. RESULTS: The frequency of clinical deterioration was 14.8% (318 episodes/89 patients). Unreported deterioration decreased each year (86.7%; 68.8%; 55.3%; 54.0%, p=0.141). Patients who deteriorated during ED care had a longer median ED length of stay (2.8h; p<0.001), were 31.9% more likely to need hospital admission (p<0.001) and 4.9% more likely to die in hospital (p=0.044). CONCLUSIONS: A staged ED specific RRS decreased the frequency of unreported clinical deterioration. Controlled multi-site studies of ED specific RRSs are needed to examine the effect of formal ED RRSs on patient outcomes.
Language eng
DOI 10.1016/j.aenj.2015.07.001
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
1110 Nursing
1117 Public Health And Health Services
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2015, Wiley
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Document type: Journal Article
Collections: School of Nursing and Midwifery
Quality and Patient Safety Research
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