You are not logged in.
Openly accessible

Physiological antecedents and ward clinician responses before medical emergency team activation

Sprogis, Stephanie K., Currey, Judy, Considine, Julie, Baldwin, Ian and Jones, Daryl 2017, Physiological antecedents and ward clinician responses before medical emergency team activation, Critical care and resuscitation, vol. 19, no. 1, pp. 50-56.

Attached Files
Name Description MIMEType Size Downloads
sprogis-physiological-2017.pdf Published version application/pdf 218.68KB 11

Title Physiological antecedents and ward clinician responses before medical emergency team activation
Author(s) Sprogis, Stephanie K.ORCID iD for Sprogis, Stephanie K. orcid.org/0000-0003-4259-6976
Currey, JudyORCID iD for Currey, Judy orcid.org/0000-0002-0574-0054
Considine, JulieORCID iD for Considine, Julie orcid.org/0000-0003-3801-2456
Baldwin, Ian
Jones, Daryl
Journal name Critical care and resuscitation
Volume number 19
Issue number 1
Start page 50
End page 56
Total pages 7
Publisher College of Intensive Care Medicine of Australia and New Zealand
Place of publication Prahran, Vic.
Publication date 2017-03
ISSN 1441-2772
Summary OBJECTIVES: To investigate the frequency, characteristics and timing of objectively measured clinical instability in adult ward patients in the 24 hours preceding activation of the medical emergency team (MET). We also examined ward clinician responses to documented clinical instability.

DESIGN, SETTING AND PARTICIPANTS: A descriptive, exploratory design with a retrospective medical record audit. We descriptively analysed data from 200 ward patients reviewed by the MET at a tertiary teaching hospital in Melbourne, Australia, during 2014.

MAIN OUTCOME MEASURES: Frequency and characteristics of urgent clinical review (UCR) criteria breaches in the 24 hours preceding MET activation, and in-hospital mortality.

RESULTS: Overall, 78.5% of patients breached UCR criteria at least once in the 24 hours preceding MET activation, with 80.9% having multiple breaches. The most common causes of UCR criteria breaches were hypoxaemia without supplemental oxygen (27.4%, n = 43) and hypoxaemia with supplemental oxygen (21.7%, n = 34) for first UCR criteria breaches, and tachycardia (33.1%, n = 42) for last UCR criteria breaches during the 24 hours we examined. The median time before MET activation for first and last breaches was 17.1 hours and 1.2 hours, respectively. Examination of the clinician documentation suggested a high incidence of pre-MET activation afferent limb failure. In-hospital mortality was 12%.

CONCLUSIONS: Patients commonly and repeatedly breached objectively measured UCR criteria in the 24 hours preceding MET activation, providing numerous opportunities for clinicians to recognise and respond to early clinical deterioration. The high incidence of pre- MET afferent limb failure requires further exploration.
Language eng
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2017, College of Intensive Care Medicine of Australia and New Zealand
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30091561

Connect to link resolver
 
Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved.

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.

Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 0 times in TR Web of Science
Scopus Citation Count Cited 0 times in Scopus
Google Scholar Search Google Scholar
Access Statistics: 43 Abstract Views, 12 File Downloads  -  Detailed Statistics
Created: Wed, 01 Mar 2017, 07:15:24 EST

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.