Rapid Response Teams Decreasing Intubation and Code Blue Rates Outside the Intensive Care Unit

2016 ◽  
Vol 36 (1) ◽  
pp. 86-90 ◽  
Author(s):  
Elizabeth Avis ◽  
Lois Grant ◽  
Erin Reilly ◽  
Marybeth Foy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Rapid Response ◽  
Rapid Response Teams ◽  
Code Blue

scholarly journals Effect of a Rapid Response Team on Patient Outcomes in a Community-Based Teaching Hospital

2014 ◽  
Vol 6 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Ankur Segon ◽  
Shahryar Ahmad ◽  
Yogita Segon ◽  
Vivek Kumar ◽  
Harvey Friedman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Outcomes ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Inpatient Mortality ◽  
Rapid Response Teams ◽  
Community Based ◽  
Code Blue ◽  
Response Team

Abstract Background Rapid response teams have been adopted across hospitals to reduce the rate of inpatient cardiopulmonary arrest. Yet, data are not uniform on their effectiveness across university and community settings. Objective The objective of our study was to determine the impact of rapid response teams on patient outcomes in a community teaching hospital with 24/7 resident coverage. Methods Our retrospective chart review of preintervention-postintervention data included all patients admitted between January 2004 and April 2006. Rapid response teams were initiated in March 2005. The outcomes of interest were inpatient mortality, unexpected transfer to the intensive care unit, code blue (cardiac or pulmonary arrest) per 1000 discharges, and length of stay in the intensive care unit. Results Rapid response teams were activated 213 times during the intervention period. There was no statistically significant difference in inpatient mortality (3.13% preintervention versus 2.91% postintervention), code blue calls (3.09 versus 2.89 per 1000 discharges), or unexpected transfers of patients to the intensive care unit (15.8% versus 15.5%). Conclusions The implementation of a rapid response team did not appear to affect overall mortality and code blue calls in a community-based hospital with 24/7 resident coverage.

Factors Associated With Rapid Response Call Conversion To Code Blue Or Intensive Care Unit (ICU) Admission

2012 ◽  
Author(s):  
Jennifer Maguire ◽  
Shannon S. Carson ◽  
Loc Culp ◽  
Celeste Mayer ◽  
Renae E. Stafford ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Rapid Response ◽  
Factors Associated ◽  
Icu Admission ◽  
Code Blue

Designing a Critical Care Nurse–Led Rapid Response Team Using Only Available Resources: 6 Years Later

2014 ◽  
Vol 34 (3) ◽  
pp. 41-56 ◽  
Author(s):  
Anne Mitchell ◽  
Marilyn Schatz ◽  
Heather Francis
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Patient Safety ◽  
Intensive Care ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Rapid Response Teams ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Response Team

Rapid response teams have been introduced to intervene in the care of patients whose condition deteriorates unexpectedly by bringing clinical experts quickly to the patient’s bedside. Evidence supporting the need to overcome failure to deliver optimal care in hospitals is robust; whether rapid response teams demonstrate benefit by improving patient safety and reducing the occurrence of adverse events remains controversial. Despite inconsistent evidence regarding the effectiveness of rapid response teams, concerns regarding care and costly consequences of unaddressed deterioration in patients’ condition have prompted many hospitals to implement rapid response teams as a patient safety strategy. A cost-neutral structure for a rapid response team led by a nurse from the intensive care unit was implemented with the goal of reducing cardiopulmonary arrests occurring outside the intensive care unit. The results of 6 years’ experience indicate that a sustainable and effective rapid response team response can be put into practice without increasing costs or adding positions and can decrease the percentage of cardiopulmonary arrests occurring outside the intensive care unit. (Critical Care Nurse. 2014; 34[3]:41–56)

Code Blue Events in the Neonatal and Pediatric Intensive Care Units at a Tertiary Care Children's Hospital

2020 ◽  
Author(s):  
Catherine M. Groden ◽  
Erwin T. Cabacungan ◽  
Ruby Gupta
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Life Support ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Neonatal Resuscitation ◽  
Advanced Life Support ◽  
Pediatric Intensive Care ◽  
Code Blue ◽  
Neonatal Resuscitation Program

Objective The authors aim to compare all code blue events, regardless of the need for chest compressions, in the neonatal intensive care unit (NICU) versus the pediatric intensive care unit (PICU). We hypothesize that code events in the two units differ, reflecting different disease processes. Study Design This is a retrospective analysis of 107 code events using the code narrator, which is an electronic medical record of real-time code documentation, from April 2018 to March 2019. Events were divided into two groups, NICU and PICU. Neonatal resuscitation program algorithm was used for NICU events and a pediatric advanced life-support algorithm was used for PICU events. Events and outcomes were compared using univariate analysis. The Mann–Whitney test and linear regressions were done to compare the total code duration, time from the start of code to airway insertion, and time from airway insertion to end of code event. Results In the PICU, there were almost four times more code blue events per month and more likely to involve patients with seizures and no chronic condition. NICU events more often involved ventilated patients and those under 2 months of age. The median code duration for NICU events was 2.5 times shorter than for PICU events (11.5 vs. 29 minutes), even when adjusted for patient characteristics. Survival to discharge was not different in the two groups. Conclusion Our study suggests that NICU code events as compared with PICU code events are more likely to be driven by airway problems, involve patients <2 months of age, and resolve quickly once airway is taken care of. This supports the use of a ventilation-focused neonatal resuscitation program for patients in the NICU. Key Points

A novel configuration of a traditional rapid response team decreases non-intensive care unit arrests and overall hospital mortality

2015 ◽  
Vol 10 (6) ◽  
pp. 352-357 ◽  
Author(s):  
Daniel P. Davis ◽  
Steve A. Aguilar ◽  
Patricia G. Graham ◽  
Brenna Lawrence ◽  
Rebecca E. Sell ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Response Team

scholarly journals Relationship between the presence of dedicated doctors in rapid response systems and patient outcome: a multicenter retrospective cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hyung-Jun Kim ◽  
Kyeongman Jeon ◽  
Byung Ju Kang ◽  
Jong-Joon Ahn ◽  
Sang-Bum Hong ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Propensity Score ◽  
Intensive Care Unit Admission ◽  
Hazard Ratio ◽  
Rapid Response ◽  
Admission Rates ◽  
Rapid Response Systems ◽  
Response Systems

Abstract Background Rapid response systems (RRSs) improve patients’ safety, but the role of dedicated doctors within these systems remains controversial. We aimed to evaluate patient survival rates and differences in types of interventions performed depending on the presence of dedicated doctors in the RRS. Methods Patients managed by the RRSs of 9 centers in South Korea from January 1, 2016, through December 31, 2017, were included retrospectively. We used propensity score-matched analysis to balance patients according to the presence of dedicated doctors in the RRS. The primary outcome was in-hospital survival. The secondary outcomes were the incidence of interventions performed. A sensitivity analysis was performed with the subgroup of patients diagnosed with sepsis or septic shock. Results After propensity score matching, 2981 patients were included per group according to the presence of dedicated doctors in the RRS. The presence of the dedicated doctors was not associated with patients’ overall likelihood of survival (hazard ratio for death 1.05, 95% confidence interval [CI] 0.93‒1.20). Interventions, such as arterial line insertion (odds ratio [OR] 25.33, 95% CI 15.12‒42.44) and kidney replacement therapy (OR 10.77, 95% CI 6.10‒19.01), were more commonly performed for patients detected using RRS with dedicated doctors. The presence of dedicated doctors in the RRS was associated with better survival of patients with sepsis or septic shock (hazard ratio for death 0.62, 95% CI 0.39‒0.98) and lower intensive care unit admission rates (OR 0.53, 95% CI 0.37‒0.75). Conclusions The presence of dedicated doctors within the RRS was not associated with better survival in the overall population but with better survival and lower intensive care unit admission rates for patients with sepsis or septic shock.

scholarly journals Findings of the First ANZICS Conference on the Role of Intensive Care in Rapid Response Teams

2015 ◽  
Vol 43 (3) ◽  
pp. 369-379 ◽  
Author(s):  
D. Jones ◽  
P. Hicks ◽  
J. Currey ◽  
J. Holmes ◽  
G. J. Fennessy ◽  
...  
Keyword(s):  
Intensive Care ◽  
Rapid Response ◽  
Rapid Response Teams

Early Warning Score Communication Bundle: A Pilot Study

2018 ◽  
Vol 27 (3) ◽  
pp. 238-242
Author(s):  
Cheryl Gagne ◽  
Susan Fetzer
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Early Warning ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Early Warning Score ◽  
Early Warning Scores ◽  
Response Team ◽  
Intensive Care Unit Nurses ◽  
The Impact

Background Unplanned admissions of patients to intensive care units from medical-surgical units often result from failure to recognize clinical deterioration. The early warning score is a clinical decision support tool for nurse surveillance but must be communicated to nurses and implemented appropriately. A communication process including collaboration with experienced intensive care unit nurses may reduce unplanned transfers. Objective To determine the impact of an early warning score communication bundle on medical-surgical transfers to the intensive care unit, rapid response team calls, and morbidity of patients upon intensive care unit transfer. Methods After an early warning score was electronically embedded into medical records, a communication bundle including notification of and telephone collaboration between medical-surgical and intensive care unit nurses was implemented. Data were collected 3 months before and 21 months after implementation. Results Rapid response team calls increased nonsignificantly during the study period (from 6.47 to 8.29 per 1000 patient-days). Rapid response team calls for patients with early warning scores greater than 4 declined (from 2.04 to 1.77 per 1000 patient-days). Intensive care unit admissions of patients after rapid response team calls significantly declined (P = .03), as did admissions of patients with early warning scores greater than 4 (P = .01), suggesting that earlier intervention for patient deterioration occurred. Documented reassessment response time declined significantly to 28 minutes (P = .002). Conclusion Electronic surveillance and collaboration with experienced intensive care unit nurses may improve care, control costs, and save lives. Critical care nurses have a role in coaching and guiding less experienced nurses.

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