Chen J Gene, Kemper Alex R, Odetola Folafoluwa, Cheifetz Ira M, Turner David A
Department of Pediatrics, Arnold Palmer Hospital for Children, Orlando, Florida 32806, USA.
Hosp Pediatr. 2012 Jul;2(3):133-40. doi: 10.1542/hpeds.2011-0030.
Rapid response teams (RRTs) have been proposed as patient safety initiatives for hospitalized children. The aim of this study was to determine the prevalence, characteristics, and opinions of RRTs in hospitals with PICUs in the United States.
This study was conducted as a cross-sectional survey of PICU physicians in adult and children's hospitals that care for children. One survey was sent to the PICU medical director in each hospital. The primary outcome was the presence of an RRT. Other outcomes included RRT characteristics and beliefs regarding their impact on patient safety.
The survey response rate was 64% (134 of 210). Of the responding institutions, 79% (103) had an RRT; most of these teams were implemented in the last 5 years. Family activation was present in 69%, and automatic triggers existed in 34% of cases. RRTs included a median of 3 members and were composed of physicians in 77%, nurses in 100%, and respiratory therapists in 89% of institutions. Respondents with RRTs were more likely to agree that RRTs improve patient safety than respondents without RRTs (76% vs 52%) and more likely to disagree that they are not worth the money invested (82% vs 63%).
Although the evidence and opinions on the benefit of RRTs are mixed, the majority of US hospitals with PICUs have implemented RRTs. These systems demonstrate variability in activation mechanisms and team composition. Hospitals may be empirically adopting these initiatives without knowledge of the specific characteristics that are optimal for patient outcomes.
快速反应团队（RRTs）已被提议作为针对住院儿童的患者安全举措。本研究的目的是确定美国设有儿科重症监护病房（PICUs）的医院中RRTs的患病率、特征及看法。
本研究作为一项横断面调查，针对收治儿童的成人及儿童医院的PICU医生展开。向每家医院的PICU医疗主任发送一份调查问卷。主要结果是RRT的存在情况。其他结果包括RRT的特征以及关于其对患者安全影响的看法。
调查回复率为64%（210份中的134份）。在做出回复的机构中，79%（103家）设有RRT；其中大多数团队是在过去5年内实施的。69%的团队存在家庭激活机制，34%的情况存在自动触发机制。RRT的成员中位数为3人，77%的机构团队成员包括医生，100%包括护士，89%包括呼吸治疗师。设有RRT的受访者比未设RRT的受访者更倾向于认同RRT能提高患者安全（76%对52%），也更倾向于不认同RRT不值得投入资金（82%对63%）。
尽管关于RRT益处的证据和看法不一，但美国大多数设有PICUs的医院已实施RRTs。这些系统在激活机制和团队组成方面存在差异。医院可能在未了解对患者预后最有利的具体特征的情况下凭经验采用这些举措。
