Mininni Nicolette C, Whiteman Kimberly, Stephens Kimberly, George Elisabeth, Swanson-Biearman Brenda
University of Pittsburg Medical Center (UPMC) Shadyside, Pittsburgh, Pennsylvania (Drs Mininni and George); and Waynesburg University, Waynesburg, Pennsylvania (Drs Whiteman, Stephens, and Swanson-Biearman).
J Nurs Care Qual. 2023;38(2):134-140. doi: 10.1097/NCQ.0000000000000669. Epub 2022 Oct 12.
Rapid response teams (RRTs) are designed to improve patient care during deterioration in clinical condition.
Patients' desired limitations of medical therapy (LOMTs) were not documented or communicated to the RRT, and patients received care not aligned with their wishes.
A multidisciplinary team developed a process for improving documentation, communication of LOMTs, and care delivery on 3 medical cardiology units. The team implemented 3 Plan-Do-Study-Act (PDSA) cycles over 6 months.
In cycle 1, team members taught the unit nurses, RRT members, and physicians to share LOMTs during handoff communications. Cycle 2 engaged case managers in LOMT documentation. In cycle 3, unit-based RRT simulation was conducted.
All care delivered by the RRT aligned with the documented LOMTs. Documentation of LOMTs increased from 76% to 82.5% ( P = .014).
Education, scripting, and simulation were successful strategies to ensure that care given during RRT events aligned with patients' wishes.
快速反应团队（RRTs）旨在改善临床病情恶化期间的患者护理。
患者期望的医疗治疗限制（LOMTs）未被记录或传达给快速反应团队，患者接受的护理与他们的意愿不符。
一个多学科团队制定了一个流程，以改善3个心内科病房的LOMTs记录、沟通及护理提供情况。该团队在6个月内实施了3个计划-实施-研究-改进（PDSA）循环。
在第1个循环中，团队成员教导病房护士、快速反应团队成员和医生在交接班沟通时分享LOMTs。第2个循环让个案管理员参与LOMTs记录。在第3个循环中，进行了基于病房的快速反应团队模拟。
快速反应团队提供的所有护理都与记录的LOMTs一致。LOMTs的记录从76%增加到82.5%（P = .014）。
教育、脚本编写和模拟是成功的策略，可确保快速反应团队事件期间提供的护理符合患者意愿。
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