Data Science Team, Orion Health, Auckland, New Zealand.
School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland, New Zealand.
Inform Health Soc Care. 2021 Jun 2;46(2):148-157. doi: 10.1080/17538157.2021.1873349. Epub 2021 Jan 21.
The aim of this study was to investigate the effectiveness of current rapid response applications available in acute care settings for escalation of patient deterioration. Current challenges and barriers, as well as key recommendations, were also discussed.
We adopted PRISMA review methodology and screened a total of 559 articles. After considering the eligibility and selection criteria, we selected 13 articles published between 2015 and 2019. The selection criteria were based on the inclusion of studies that report on the advancement made to the current practice for providing rapid response to the patient deterioration in acute care settings.
We found that current rapid response applications are complicated and time-consuming for detecting inpatient deterioration. Existing applications are either siloed or challenging to use, where clinicians are required to move between two or three different applications to complete an end-to-end patient escalation workflow - from vital signs collection to escalation of deteriorating patients. We found significant differences in escalation and responses when using an electronic tool compared to the manual approach. Moreover, encouraging results were reported in extensive documentation of vital signs and timely alerts for patient deterioration.
The electronic vital signs monitoring applications are proved to be efficient and clinically suitable if they are user-friendly and interoperable. As an outcome, several key recommendations and features were identified that would be crucial to the successful implementation of any rapid response system in all clinical settings.
本研究旨在探讨目前在急症护理环境中可用于患者病情恶化升级的快速反应应用的有效性。还讨论了当前的挑战和障碍，以及关键建议。
我们采用了 PRISMA 审查方法，共筛选了 559 篇文章。在考虑了资格和选择标准后，我们选择了 2015 年至 2019 年期间发表的 13 篇文章。选择标准基于纳入的研究报告，这些研究报告报告了为在急症护理环境中为患者病情恶化提供快速反应而对当前实践的改进。
我们发现，目前的快速反应应用程序在检测住院患者病情恶化方面既复杂又耗时。现有的应用程序要么孤立无援，要么难以使用，临床医生需要在两个或三个不同的应用程序之间切换，以完成端到端的患者升级工作流程 - 从生命体征采集到病情恶化患者的升级。与手动方法相比，我们发现使用电子工具在升级和响应方面存在显著差异。此外，在广泛记录生命体征和及时发出患者恶化警报方面，报告了令人鼓舞的结果。
如果电子生命体征监测应用程序易于使用且具有互操作性，则被证明是高效且临床适用的。作为结果，确定了几个关键建议和功能，这些对于在所有临床环境中成功实施任何快速反应系统都至关重要。
