Cretikos Michelle A, Chen Jack, Hillman Ken M, Bellomo Rinaldo, Finfer Simon R, Flabouris Arthas
The Simpson Centre for Health Services Research, and the University of New South Wales, Sydney, NSW, Australia.
Crit Care Resusc. 2007 Jun;9(2):205-12.
The potential of the medical emergency team (MET) system to reduce adverse events may depend on the effectiveness of its implementation. We aimed to evaluate the effectiveness of the implementation of the MET system during the MERIT (Medical Early Response, Intervention and Therapy) study and to determine factors associated with the level of MET system utilisation.
Surveys were conducted on the nursing staff from the general adult wards of all 12 MERIT study intervention hospitals after the 4-month implementation period and again after the 6-month study period. Hospital level variables were assessed for their correlation with MET utilisation. We measured awareness and understanding of the MET system, attendance at a MET education session, knowledge of the activation criteria, intention to call the MET, attitude to the MET system and the level of MET utilisation.
Across the 12 intervention hospitals, a median of 85.6% (interquartile range, 81.3%-88.8%) of MET activations were not related to a cardiac arrest or death. This measure of MET system utilisation varied significantly across the 12 hospitals (P = 0.002), and was significantly associated with knowledge of the activation criteria (P = 0.048), understanding of the purpose of the MET system (P = 0.01), perceptions of the hospital's readiness for a change in the way care was provided (P = 0.004), and an overall positive attitude to the MET system (P = 0.003).
Measures of the process of implementation of the MET system were significantly associated with the level of MET system utilisation.
医疗急救团队（MET）系统减少不良事件的潜力可能取决于其实施的有效性。我们旨在评估MERIT（医疗早期反应、干预和治疗）研究期间MET系统实施的有效性，并确定与MET系统使用水平相关的因素。
在4个月的实施期后以及6个月的研究期后，对所有12家MERIT研究干预医院的普通成人病房的护理人员进行了调查。评估医院层面的变量与MET使用情况的相关性。我们测量了对MET系统的知晓和理解、参加MET教育课程的情况、对启动标准的了解、呼叫MET的意愿、对MET系统的态度以及MET的使用水平。
在12家干预医院中，MET激活事件的中位数为85.6%（四分位间距，81.3%-88.8%）与心脏骤停或死亡无关。MET系统使用情况的这一指标在12家医院中差异显著（P = 0.002），并且与启动标准的知识（P = 0.048）、对MET系统目的的理解（P = 0.01）、对医院在护理提供方式改变方面准备情况的认知（P = 0.004）以及对MET系统的总体积极态度（P = 0.003）显著相关。
MET系统实施过程的指标与MET系统使用水平显著相关。
