Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 1-2-3 Kasumi, Minami-ku, Hiroshima.
Department of Anesthesiology and Reanimatology, Faculty of Medical Sciences, University of Fukui, 23-3 Eiheijicho, Yoshidagun, Fukui.
Medicine (Baltimore). 2021 Jun 11;100(23):e26261. doi: 10.1097/MD.0000000000026261.
The rapid response system (RRS) was introduced for early stage intervention in patients with deteriorating clinical conditions. Responses to unexpected in-hospital patient emergencies varied among hospitals. This study was conducted to understand the prevalence of RRS in smaller hospitals and to identify the need for improvements in the responses to in-hospital emergencies.A questionnaire survey of 971 acute-care hospitals in western Japan was conducted from May to June 2019 on types of in-hospital emergency response for patients in cardiac arrest (e.g., medical emergency teams [METs]), before obvious deterioration (e.g., rapid response teams [RRTs]), and areas for improvement.We received 149 responses, including those from 56 smaller hospitals (≤200 beds), which provided fewer responses than other hospitals. Response systems for cardiac arrest were used for at least a limited number of hours in 129 hospitals (87%). The absence of RRS was significantly more frequent in smaller hospitals than in larger hospitals (13/56, 23% vs 1/60, 2%; P < .01). METs and RRTs operated in 17 (11%) and 15 (10%) hospitals, respectively, and the operation rate for RRTs was significantly lower in smaller hospitals than in larger hospitals (1/56, 2% vs 12/60, 20%; P < .01). Respondents identified the need for education and more medical staff and supervisors; data collection or involvement of the medical safety management sector was ranked low.The prevalence of RRS or predetermined responses before obvious patient deterioration was ≤10% in small hospitals. Specific education and appointment of supervisors could support RRS in small hospitals.
快速反应系统（RRS）用于对临床病情恶化的患者进行早期干预。不同医院对住院患者意外紧急情况的反应各不相同。本研究旨在了解较小医院 RRS 的普及程度，并确定改进住院紧急情况反应的必要性。
2019 年 5 月至 6 月，对日本西部 971 家急症护理医院进行了问卷调查，内容涉及心脏骤停（例如，医疗急救小组[MET]）、明显恶化前（例如，快速反应小组[RRT]）的住院患者各种紧急情况的反应类型，以及需要改进的地方。
我们共收到 149 份回复，其中包括 56 家较小医院（≤200 张病床）的回复，这些医院的回复数量少于其他医院。至少有 129 家医院（87%）使用了心脏骤停的 RRS，其中 RRS 在较小医院的缺失率明显高于较大医院（13/56，23% vs. 1/60，2%；P<.01）。MET 和 RRT 分别在 17 家和 15 家医院运行，RRT 在较小医院的运行率明显低于较大医院（1/56，2% vs. 12/60，20%；P<.01）。受访者认为需要加强教育和增加医务人员和主管人员；数据收集或医疗安全管理部门的参与排名较低。
在小医院，RRS 或明显病情恶化前的预定反应的普及率≤10%。特定的教育和主管人员的任命可以为小医院的 RRS 提供支持。
