Leach Linda Searle, Mayo Ann, O'Rourke Maria
UCLA School of Nursing, Los Angeles, California 90095-6917, USA.
Qual Saf Health Care. 2010 Oct;19(5):e13. doi: 10.1136/qshc.2008.030494. Epub 2010 Apr 8.
Patients are admitted to hospitals everyday with clinical conditions that can change dynamically resulting in adverse outcomes. The rapid response team (RRT) intervention is a formalised resource to respond to the nurse's concerns about such patients before code arrest occurs. Registered nurses (RNs) are in a position to recognise critical changes and to rescue patients at the most opportune moments, but little is known about how RNs rescue patients using these increasingly popular teams. Our aims were to investigate how RNs rescue patients in hospitals where RRTs are in place.
Fifty participants involved with RRTs participated in semistructured individual interviews in six California hospitals. Data were analysed using coding and constant comparison methods.
Overall, RNs view RRTs as a helpful and effective safety intervention. RRT RNs and bedside RNs support one another in a synergistic way to prevent adverse patient events during the rescuing process. However, traditional hierarchies and relationships with physicians and supervisors impede some components of RN decision-making during rescuing.
RNs find the RRT supportive when their patient is at risk or care needs are changing. They benefit from a formalised mechanism that enables immediate access to resources. RRT RNs in this study applied their expertise with critically ill patients to rescue medical and surgical patients. The RRT RN and bedside RNs' interaction influenced the rescuing process. Their role synergy was a value-added contribution to preventing adverse events and to improving patient safety by RNs.
每天都有患有可能动态变化并导致不良后果的临床病症的患者入院。快速反应小组（RRT）干预是一种正式资源，用于在患者心跳骤停发生前回应护士对这类患者的担忧。注册护士（RN）有能力识别关键变化并在最恰当的时刻抢救患者，但对于RN如何利用这些日益普及的小组抢救患者却知之甚少。我们的目的是调查在设有RRT的医院中RN如何抢救患者。
五十名参与RRT的参与者在加利福尼亚州的六家医院参加了半结构化的个人访谈。使用编码和持续比较方法对数据进行分析。
总体而言，RN认为RRT是一种有用且有效的安全干预措施。RRT的RN和床边RN以协同的方式相互支持，以防止在抢救过程中发生不良患者事件。然而，与医生和上级的传统等级制度及关系在抢救过程中阻碍了RN决策的某些环节。
当患者处于危险中或护理需求发生变化时，RN发现RRT很有帮助。他们受益于一种能够立即获取资源的正式机制。本研究中的RRT RN将他们对重症患者的专业知识应用于抢救内科和外科患者。RRT RN与床边RN的互动影响了抢救过程。他们的角色协同作用对预防不良事件和提高RN的患者安全起到了增值作用。
