Salvatierra Gail G, Bindler Ruth C, Daratha Kenn B
Assistant Professor, School of Nursing, California State University, San Marcos, CA, USA.
Professor Emeritus, College of Nursing, Washington State University, Spokane, WA, USA.
J Nurs Scholarsh. 2016 Nov;48(6):616-623. doi: 10.1111/jnu.12252. Epub 2016 Sep 26.
The purpose of this article is to present an overview of rapid response team (RRT) history in the United States, provide a review of prior RRT effectiveness research, and propose the reframing of four new questions of RRT measurement that are designed to better understand RRTs in the context of contemporary nursing practice as well as patient outcomes.
RRTs were adopted in the United States because of their intuitive appeal, and despite a lack of evidence for their effectiveness. Subsequent studies used mortality and cardiac arrest rates to measure whether or not RRTs "work." Few studies have thoroughly examined the effect of RRTs on nurses and on nursing practice.
An extensive literature review provided the background. Suppositions and four critical, unanswered questions arising from the literature are suggested.
The results of RRT effectiveness, which have focused on patient-oriented outcomes, have been ambiguous, contradictory, and difficult to interpret. Additionally, they have not taken into account the multiple ways in which these teams have impacted nurses and nursing practice as well as patient outcomes.
What happens in terms of RRT process and utilization is likely to have a major impact on nurses and nursing care on general medical and surgical wards. What that impact will be depends on what we can learn from measuring with an expanded yardstick, in order to answer the question, "Do RRTs work?"
Evidence for the benefits of RRTs depends on proper framing of questions relating to their effectiveness, including the multiple ways RRTs contribute to nursing efficacy.
本文旨在概述美国快速反应小组(RRT)的发展历程,回顾以往关于RRT有效性的研究,并提出重新构建四个有关RRT衡量的新问题,这些问题旨在在当代护理实践及患者预后的背景下更好地理解RRT。
RRT在美国被采用是因其直观的吸引力,尽管缺乏其有效性的证据。随后的研究使用死亡率和心脏骤停率来衡量RRT是否“有效”。很少有研究全面考察RRT对护士及护理实践的影响。
广泛的文献综述提供了背景。文中提出了基于文献的假设及四个关键的、尚未解答的问题。
聚焦于以患者为导向的结果的RRT有效性研究结果一直不明确、相互矛盾且难以解读。此外,这些研究没有考虑到这些小组对护士、护理实践以及患者预后产生影响的多种方式。
RRT的流程及使用情况可能会对普通内科和外科病房的护士及护理产生重大影响。这种影响如何取决于我们能否从使用更广泛的衡量标准中有所收获,从而回答“RRT是否有效?”这一问题。
RRT益处的证据取决于与其实效性相关问题的恰当构建,包括RRT对护理效能产生影响的多种方式。