Template for Draft Reports - National Center for ...



134BEvidence Tables for Chapter 24. Rapid Response Systems (NEW)Table 1, Chapter 24. RRS evidence table: effectivenessAuthor, yearDescription of PSPMulti-componentStudy DesignSample SizeTheory or Logic ModelDescription of OrganizationContextsImplementation DetailsOutcomes: BenefitsOutcomes: HarmsInfluence of Contexts on OutcomesCommentsAnwar ul, 2010 QUOTE "1" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\011\01\01\00\01\00\00\01\00\00\00\1BM_\00\00\00\00\18?|\01@?\11\01\01\00\00\008\00\00\00\00\00\00\00\00\003\00\5C\01\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt"Anwar ul, Saleem, et al. 2010 #349\00"\00 1PICU physicians (Pediatric MET)Pre-post9340NA600 bed tertiary teaching hospital (75 pediatric beds) in PakistanEducation sessions with quarterly reinforcementMortality : ICU mortality of patients admitted to ICU from floor (total sample 77)Results:50% to 15%Statistics: p=0.001 OR 0.18 (0.09-0.35)Cardiac arrest: Results: 5.2 to 2.7/1000 admitsStatistics: p=0.004 OR=.52 (0.12-2.26)Bader, 2009 QUOTE "2" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\012\01\01\00\01\00\00\01\00\00\00\1BM_\00\00\00\00è’\07\01@?\0E\01\01\00\00\008\00\00\00\00\00\00\008\00\00\00%\02\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt\1DBader, Neal, et al. 2009 #550\00\1D\00 2Nurse led. Had Critical care outreach component as well (proactive rounding on ICU discharged patients and also responded to ED (most RRS don’t go to the ED.)RRT model with CCOT functionPre-postnot givenNA304 bed acute care non-teaching hospital, part of large health system including 13 other hospitals in anizational characteristics: Director of quality<br>Leadership: Leadership team12 month review and development of RRT, activation criteria, integration into ED nursing, development of CCOT component followed by rapid cycle pilot test then full implementation.Mortality : non-ICU arrestsResults:61% to 26%Statistics: p<0.05Cardiac arrest: no denominatorResults: 36 to 17/yearStatistics no value given though stated to be statistically significant suggesting p<0.05Transfer to ICU per RRT callResults:21% to 14%Statistics: p<0.05Authors do not give denominator data for cardio-respiratory arrest nor mortality data though they do give denominator data for number of RRS calls. Benson, 2008 QUOTE "3" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\013\01\01\00\01\00\00\01\00\00\00\1BM_\00\00\00\00(¨\11\01??z\01\01\00\00\008\00\00\00\00\00\00\008\00\00\00?\02\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt"Benson, Mitchell, et al. 2008 #729\00"\00 31 of 4 advanced practice nurses (APN) responded to nurse initiated calls with intensivists and other disciplines involved as needed by the APN; if two calls received simultaneously ICU physician served as back up(RRT model with physician back-up)Pre-postNot reportedNA350-bed teachinghospital, USCredentialing, information and education interventions (email, newsletter articles, rounding, informational sessions at meetings), clinical practice protocols developedMortality : average mortality per monthResults:9% decrease (no actual rates or stats reported)Statistics: NRCardiac arrest: 58.7% reduction in codes per 1000 admissionsResults: 9.41 vs. 3.89Statistics p = .0065National Database of Nursing Quality Indicators (NDNQI?) Failure to Rescue rateResults:19.5% reduction (no actual rates or stats reported)Statistics: NRCampello, 2009 QUOTE "4" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\014\01\01\00\01\00\00\01\00\00\00\1BM_\00\00\00\00h?\06\01\10?\08\01\01\00\00\008\00\00\00\00\00\00\008\00\00\00\0F\02\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt"Campello, Granja, et al. 2009 #528\00"\00 4MET consists of ICU physician and ICU nurseRRS and implementationPre-post88407 admissionsNA470 bed non-teaching hospital inPortugalTrained all staff in BLS then widened emergency call criteria (code) to include standard RRS criteria for deteriorating patients. Simulation training with mannequins, education, information posters.Mortality : In-hospital totalResults:5.35 (4.3-6.4) to 5.65 (4.9-6.4)1000 admitsStatistics: p=0.152Cardiac arrest: Results: 4.21 (3.3-5.2) to 3.38 (2.8-4.0)1000 admitsStatistics p=0.037cardiac arrest mortalityResults:3.65 (2.8-4.5) to 3.18 (2.6-3.8)1000 admitsStatistics: p=0.014Two data sets, one in the first 2 years after RRS and then 4 years post. Results in outcomes are for the 2-year follow-up; none of the significant differences were present at the 4-year follow-up.Chan, 2008 QUOTE "5" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\015\01\01\00\01\00\00\01\00\00\00\1BM_\00\00\00\00°?\0E\01pi|\01\01\00\00\008\00\00\00\00\00\00\008\00\00\00?\02\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt\1EChan, Khalid, et al. 2008 #716\00\1E\00 5respiratory therapy and 2 ICU nurses (RRT model)RRS and education programPre-post49171NA404 bed tertiary care academic urban medical center in USeducation program but otherwise limited infoMortality : hospital wideResults: 3.22 to 3.09/100 admitsStatistics: AOR 0.95 (0.81-1.11) p=0.52Cardiac arrest: non-ICU codesResults: 6.08 to 3.08/1000 admitsStatistics: 0.59 (0.40-0.89) p=0.01Hospital wide codes-Results: 11.2 to 7.5/1000 admitsStatistics: AOR 0.76(0.57-1.01) p=0.06Chose as a primary outcome total hospital code rate (including ICU codes) and found no benefit. ICU patients are not part of RRS exposure group. Their non-ICU (general ward) codes did drop significantly.Gerdik, 2010 QUOTE "6" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\016\01\01\00\01\00\00\01\00\00\00\1BM_\00\00\00\00 L\0F\01??\0E\01\01\00\00\008\00\00\00\00\00\00\008\00\00\00\15\01\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt!Gerdik, Vallish, et al. 2010 #278\00!\00 6respiratory therapists and critical care nurses (RRT model)RRT and educationPre-postnot givenNA696 bed academic medical center in USPilot program followed by campus wide implementation 8 months later. Worked with UHC collaborative in developing implementation. Secured stakeholders, then added patient and family activationMortality : totalResults: 32.5 vs. 31.0/1000 admitsStatistics: nsCardiac arrest: Results: 25.2 vs. 17.4/monthStatistics: none givenICU readmisssionResults: no data givenStatistics: ns changeICUs contributed FTE’s to structure team. gave mortality data/1000 admissions but gave code data per monthHanson, 2009 QUOTE "7" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\017\01\01\00\01\00\00\01\00\00\00\1BM_\00\00\00\00??z\01p”\07\01\01\00\00\008\00\00\00\00\00\00\008\00\00\00?\01\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt"Hanson, Randolph, et al. 2009 #477\00"\00 7Peds MET consists of PICU fellow, PICU resident, PICU nurse and respiratory therapyRRS and educationPre-postapproximately 11,800NA136 bed pediatric university affiliated hospital in USCriteria development, Collaborative participation (IHI), planning, education, hospital wide implementationMortality : ward (not total) but included those with DNR (i.e. expected and unexpected)Results: 1.5 vs. 0.45/1000 admitsStatistics: RR= 0.30 (0-1.04) p= 0.07Cardiac arrest: wardResults: 1.27 vs. 0.45/1000 admitsStatistics RR= 0.35 (0-1.24) p=0.126time between codesResults: 2512 to 9418 patient daysStatistics: not givenTotal hospital mortalityResults: 9.64 vs. 7.31/1000 admitsStatistics: RR=0.076 (0-1.03) p= 0.078Hatler, 2009 QUOTE "8" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\018\01\01\00\01\00\00\01\00\00\00\1BM_\00\00\00\00\08?\0E\01à?\0E\01\01\00\00\008\00\00\00\00\00\00\008\00\00\00?\01\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt\1EHatler, Mast, et al. 2009 #475\00\1E\00 8ICU nurse and respiratory therapy (RRT model)RRT and educationPre-post50209NA620 bed not-for profit urban non-teaching hospital in USTeam structure, alert criteria, documentation development, educationCardiac arrest: Results: 0.93 vs. 0.63/1000 dischargeStatistics not given, may be nsKonrad, 2010 QUOTE "9" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\019\01\01\00\01\00\00\01\00\00\00\1BM_\00\00\00\00\18?z\01 “\07\01\01\00\00\008\00\00\00\00\00\00\008\00\00\00?\00\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt#Konrad, Jaderling, et al. 2010 #228\00#\00 9MET consists of ICU nurse and ICU physicianafferent and efferent limbs, educationPre-post277717 admissionsNA900 bed teaching hospital in Swedendirect and online intranet education, pocket cards for alert criteria with an education period during the initial implementationMortality : adjusted totalResults: RR 0.9Statistics: p=0.003Cardiac arrest: Results: 1.12 vs. 0.83/1000 admissionsStatistics p=0.035180 day mortalityResults: 37% vs. 15.8% Statistics: NRLOSResults: no changeAdjusted mortality was significantly decreased in both medical and surgical patientsOnly study to report long-term mortalityKotsakis, 2011 QUOTE "10" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\0210\01\01\00\02\00\00\01\00\00\00\1BM_\00\00\00\00\00?\0E\01`?\07\01\01\00\00\008\00\00\00\00\00\00\008\00\00\008\00\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt Kotsakis, Lobos, et al. 2011 #57\00 \00 10Peds MET consists of Peds ICU attending and/or fellow, respiratory therapists and ICU nurse available to inpatients on general wards via paging. Had family activation. MET and Code team were same group of people (unified team)Pre-post111432 hospital admissionsNA4 tertiary level pediatric hospitals Canada. Hospital sizes not given.External : Funded by Ministry of Health3 phases, development 1.education phase 2. pilot phase when team only avail M-F during day3.Full 24/7 7d/week implementation. MET and Code Blue Team were the same group (unified team)Mortality: total hospital mortality: 10 vs. 9.6/1000 admitsStatistics: NSCardiac arrests: Results: 1.9 vs.1.8/ 1000 admitsStatistics: NSICU mortalityResults: 0.3 vs. 0.1/ 1000 hospital admitsStatistics: p=0.05ICU readmissionResults: NRStatistics: NRProspectively collected after implementationLaurens, 2011 QUOTE "11" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\0211\01\01\00\02\00\00\01\00\00\00\1BM_\00\00\00\00x’\07\01@R\07\01\01\00\00\008\00\00\00\00\00\00\008\00\00\004\00\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt\18Laurens & Dwyer 2011 #53\00\18\00 11MET consisted of anesthesiologist, medical house officer and ICU/ED nurse. responds to any patient outside ICUdescribes the alert criteria, education process and RRS processPre-post96000 admissionsNA150 bed regional teaching hospital in AustraliaOne month education program prior to introduction of the MET with ongoing education. Formal training for MET team members and index cards for staff with alert criteriaMortality: unadjusted hospitalResults: 9.9 vs. 7.5/ 1000 admissionsStatistics: RRR=24.2% p=0.003Cardiac arrests:Results: 77 vs. 42/1000 admitsStatistics: RRR=45.5% p=0.0025ICU admissionsResults: 22.4 to 17.6/ 1000 admissionsStatistics: RRR=21.4% p=0.003Decline in cardiac arrests may have been affected by increase in number of patient deemed Do Not Resuscitate by the team; use of MET was low, denominator based on average annual admits, did not give the exact number. Did not give confidence intervals. Did not present cardiac arrest data/1000 admits in text, only in graph.Lighthall, 2010 QUOTE "12" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\0212\01\01\00\02\00\00\01\00\00\00\1BM_\00\00\00\00hg\06\01X\05\09\01\01\00\00\008\00\00\00\00\00\00\008\00\00\00?\00\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt#Lighthall, Parast, et al. 2010 #215\00#\00 12MET consisted of ICU fellow, anesthesiologist, ICU tending, ICU nurse, pharmacist, respiratory therapist available 24/7 to general ward patientsPre-postunclearNA150 bed VA hospital affiliated with a university medical schoolImplemented after a 4 month education periodMortality : allResults: 2.71 vs. 2.24/100 dischargesStatistics: p=0.04Mortality: non-DNRResults: 0.68 vs.0.39/ 100 dischargesStatistics: p=0.003Cardiac arrest: Results: 10.1 vs. 4.36/100 dischargesStatistics p<0.01Results for mortality were no longer significant after adjusting for secular trends in mortality; reduction in arrests was not significant until 10 months after RRS implementation; potential underutilization of the team; gives annual admissions but not the actual number of discharges/admissions as a denominatorRothberg, 2011 QUOTE "13" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\0213\01\01\00\02\00\00\01\00\00\00\1BM_\00\00\00\00è?z\01è?\0E\01\01\00\00\008\00\00\00\00\00\00\008\00\00\00\1F\07\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt%Rothberg, Belforti, et al. 2011 #1908\00%\00 13Hospitalist-led MET including critical care nurse, respiratory therapist, intravenoustherapist, and patient’s physician (ICU physician served as back up)Time series154,382 admissionsNA670-bed tertiary teaching hospital in USImplementation tools : In accordance with the IHI programInitial implementation on 2 med floors then spread to entire hospital over 3 months; Education included meetings, e-mails, and posters; anyone could activate;75% calls from med, 20% from surgicalMortality : Overall hospital mortalityResults: 22 deaths/1000 admissions across study periodStatistics: NSCardiac arrest: Cardiac arrests did not change significantlyResults: 7.3 to 4.2/1000 admissionsStatistics p<0.0001Rate of fatal codes/1000 admissionsResults: Delta = 0.06 (no specific prepost rate reported in text, graphed in figure 4 only)Statistics: p = .65 Stratified analyses by codes within critical care vs. codes outside critical care:Codes called for medicalcrises declined for units outside critical care only; Rate of MET activation (18 calls/1000 admissions)Santamaria, 2010 QUOTE "14" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\0214\01\01\00\02\00\00\01\00\00\00\1BM_\00\00\00\00`3\07\01?–\07\01\01\00\00\008\00\00\00\00\00\00\008\00\00\00”\00\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt#Santamaria, Tobin, et al. 2010 #149\00#\00 14MET consists of ICU registrar, general medical registrar and the ICU nurse. separate code teamDescribes a MET programOther controlled study (see comments)Between 14,838 and 26,575 admissions, depending on sample pointNA400 bed tertiary teaching hospitalImplementation tools: Part of the MERIT studyCreated MET as part of MERIT study, they were a MET hospital in that studyMortality : unexpectedResults: 0.58 vs. 0.30/1000 admits in last time periodStatistics: p<0.05Cardiac arrest: Results: 0.78 vs. 0.25/1000 admits in last time periodStatistics p<0.001Unanticipated ICU admissionResults: 0.65 vs. 0.89/1000 admits in last time periodStatistics: ns Was one of the MERIT study MET hospitals but this data includes time periods beyond the MERIT study. They have several sample epochs for comparison of the longitudinal long term effects of MET -rates of calling the MET increased over each time period, as cardiac arrest and mortality rates fellSarani*, 2011 QUOTE "15" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\0215\01\01\00\02\00\00\01\00\00\00\1BM_\00\00\00\00¨i|\01?=\0E\01\01\00\00\008\00\00\00\00\00\00\008\00\00\00\1A\00\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt"Sarani, Palilonis, et al. 2011 #27\00"\00 152 separate METs one for surgery and one for medicine. Both teams have critical care nurse, pharmacy, reps therapy, resident from primary team, ICU attending or fellow during daytime and a telemedicine ICU attending at night.describes criteria for RRS and the structurePre-post140,583 dischargesNAAcademic hospital in US. Size not givenLimited, states cardiac surgical service did not participate but nothing beyond thatMortality: hospital mortalityResults: Medical: 4.29 vs. 3.23%, p<0.001; Surgical: 1.21 vs. 1.11% Statistics: nsCardiac arrestResults: 4.07 vs. 2.32/1000 discharges Statistics: p<0.001Surgical vs. medicalSignificantly higher reduction in cardiac arrest rate in medical (40%) vs. surgical (32%) (p<0.001); mortality decreased significantly only on medical service; medical service had 3 times higher cardiac arrest rate - otherwise, few differences. Describes case-mix but does not explicitly state there was adjustment.Scott, 2009 QUOTE "16" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\0216\01\01\00\02\00\00\01\00\00\00\1BM_\00\00\00\00??\0E\01@K\0F\01\01\00\00\008\00\00\00\00\00\00\008\00\00\00?\01\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt\19Scott & Elliott 2009 #389\00\19\00 16ICU nurse and respiratory therapy (RRT model)RRT and educationPre-postnot givenNA640 bed tertiary teaching hospital1 month pilot followed by house-wide implementationCardiac arrest: Results: 7 vs. 2/1000 patient daysStatistics: unknown No sample size and no statistical analysisShah*, 2011 QUOTE "17" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\0217\01\01\00\02\00\00\01\00\00\00\1BM_\00\00\00\00`\0Fy\01à?|\01\01\00\00\008\00\00\00\00\00\00\008\00\00\00\16\00\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt\1FShah, Cardenas, et al. 2011 #23\00\1F\00 17ICU nurse and respiratory therapist (RRT model)describes criteria and what constitutes a codePre-post231,305 patient days, 61,389 admissionsNA3 affiliated academic hospitals in the US.Pre-intervention period followed by a 9 month roll-out followed by full intervention periodMortality: In-hospital: Results: 2.4% vs. 2.06%, 1.94%, 2.46% in subsequent post-implementation period, respectivelyStatistics: p=0.03, 0.01,and 0.83 respectively for each post-implementation period.Cardiac arrestsResults: 0.83 vs. 0.98/1000 final periodStatistics: p=0.3 Existing in-house code team could have affected effectiveness- physicians are already available; RRT call rate was 26.7 per 1000 hospital admissionsTibballs, 2009 QUOTE "18" ADDIN PROCITE ?\11\05‘\19\02\00\00\00\0218\01\01\00\02\00\00\01\00\00\00\1BM_\00\00\00\00?P\07\01?ó\0E\01\01\00\00\008\00\00\00\00\00\00\008\00\00\00 \07\00\00gC:\5CDocuments and Settings\5Crwilson8\5CDesktop\5CPSP DRAFT report 2Dec2011\5CRRT draft\5CRRT Database 21OCT11.pdt\1CTibballs & Kinney 2009 #2034\00\1C\00 18Directed by hospital’s resuscitation officer, RN coordinating position, MET included ICU physician and RN, ED physician and RNPre-post104780 admissions pre, 138424 postNA215-bed tertiary care pediatric hospital, AustraliaIncluded intensive education, hiring additional ICU nursesMortality: total in-hospitalResults; 4.38 vs. 2.87/1000 admitsStatistics: RR= 0.65 (0.57-0.75) p<0.0001Mortality: unexpected general wardResults: 0.12 vs. 0.04/1000Statistics: RR=0.35 (0.13-0.92) p=0.03Cardiac arrest: unexpected non-ICUResults: 0.19 vs. 0.17/1000 admitsStatistics RR=0.91 (0.50-1.64) p=0.75Cardiac arrest: preventable non-ICUResults: 0.16 vs. 0.07/1000 admits Statistics: RR=0.45 (0.2-0.97) p=0.04Article also discussed issues with definitions of cardiac arrest, preventable arrest* one reviewer had indicated that the article did not apply but a subsequent reviewer included and data was availableReferences1. Anwar ul H, Saleem AF, Zaidi S, Haider SR. Experience of pediatric rapid response team in a tertiary care hospital in Pakistan. Indian J Pediatr. 2010; 77:273-6.2. Bader MK, Neal B, Johnson L et al. Jt Comm Rescue me: saving the vulnerable non-ICU patient population. J Qual Patient Saf. 2009; 35:199-205.3. Benson L, Mitchell C, Link M, Carlson G, Fisher Using an advanced practice nursing model for a rapid response team. J. Jt Comm J Qual Patient Saf. 2008; 34:743-7.4. Campello G, Granja C, Carvalho F, Dias C, Azevedo LF, Costa-Pereira A. Immediate and long-term impact of medical emergency teams on cardiac arrest prevalence and mortality: a plea for periodic basic life-support training programs. Crit Care Med. 2009; 37:3054-61.5. Chan PS, Khalid A, Longmore LS, Berg RA, Kosiborod M, Spertus JA. Hospital-wide code rates and mortality before and after implementation of a rapid response team. JAMA. 2008; 300:2506-13.6. Gerdik C, Vallish RO, Miles K, Godwin SA, Wludyka PS, Panni MK. Successful implementation of a family and patient activated rapid response team in an adult level 1 trauma center. Resuscitation. 2010; 81:1676-81.7. Hanson CC, Randolph GD, Erickson JA et al. A reduction in cardiac arrests and duration of clinical instability after implementation of a paediatric rapid response system. Qual Saf Health Care. 2009; 18:500-4.8. Hatler C, Mast D, Bedker D et al. Implementing a rapid response team to decrease emergencies outside the ICU: one hospital’s experience. Medsurg Nurs. 2009; 18:84-90, 126.9. Konrad D, Jaderling G, Bell M, Granath F, Ekbom A, Martling CR. Reducing in-hospital cardiac arrests and hospital mortality by introducing a medical emergency team. Intensive Care Med. 2010; 36:100-6.10. Kotsakis A, Lobos AT, Parshuram C et al. Implementation of a Multicenter Rapid Response System in Pediatric Academic Hospitals Is Effective. Pediatrics. 2011; 128:72-8.11. Laurens N, Dwyer T. The impact of medical emergency teams on ICU admission rates, cardiopulmonary arrests and mortality in a regional hospital. Resuscitation. 2011; 82:707-12.12. Lighthall GK, Parast LM, Rapoport L, Wagner TH. Introduction of a rapid response system at a United States veterans affairs hospital reduced cardiac arrests. Anesth Analg. 2010; 111:679-86.13. Rothberg MB, Belforti R, Fitzgerald J, Friderici J, Keyes M. Four years’ experience with a hospitalist-led medical emergency team: An interrupted time series. Journal of Hospital Medicine. 2011.14. Santamaria J, Tobin A, Holmes J. Changing cardiac arrest and hospital mortality rates through a medical emergency team takes time and constant review. Crit Care Med. 2010; 38:445-50.15. Sarani B, Palilonis E, Sonnad S et al. Clinical emergencies and outcomes in patients admitted to a surgical versus medical service. Resuscitation. 2011; 82:415-8.16. Scott SS, Elliott S. Implementation of a rapid response team: a success story. Crit Care Nurse. 2009; 29:66-75; quiz 76.17. Shah SK, Cardenas VJJr, Kuo YF, Sharma G. Rapid response team in an academic institution: does it make a difference? Chest. 2011; 139:1361-7.18. Tibballs J, Kinney S. Reduction of hospital mortality and of preventable cardiac arrest and death on introduction of a pediatric medical emergency team. Pediatric Critical Care Medicine. 2009; 10:306-12+423+424+425. ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download