Effectiveness of Rapid Response Team on In-hospital Mortality in Patients with Hematologic Malignancy

Purpose: Patients with hematologic malignancy (HM) typically have a high mortality rate when their condition deteriorates. The chronic progressive course of the disease makes it difficult to assess the effect of intervention on acute events. We investigated the effectiveness of a rapid response team (RRT) on in-hospital mortality in patients with HM.Methods: We retrospectively analyzed the data of patients with HM who admitted to the medical intensive care unit between 2006 and 2015. Clinical outcomes before and after RRT implementation were evaluated.Results: A total of 228 patients in the pre-RRT period and 781 patients in the post-RRT period were included. The overall in-hospital mortality was 55.4%. Patients in the post-RRT period had improved survival; however, they required more vasopressor therapy, continuous renal replacement therapy, and extracorporeal membrane oxygenation. Multivariate analysis revealed that in-hospital mortality was associated with RRT activation (hazard ratio [HR], 0.634; 95% confidence interval [CI], 0.498–0.807; p < .001), neurological disease (HR, 2.007; 95% CI, 1.439–2.800; p < .001), sequential organ failure assessment score (HR, 1.085; 95% CI, 1.057–1.112; p < .001), need for continuous renal replacement therapy (HR, 1.608; 95% CI, 1.206–1.895; p< .001), mechanical ventilation (HR, 1.512; 95% CI, 1.206–1.895; p< .001), vasopressor (HR, 1.598; 95% CI, 1.105–2.311; p = .013), and extracorporeal membrane oxygenation (HR, 1.728; 95% CI, 1.105–2.311; p = .030).Conclusion: RRT activation may be associated with improved survival in patients with HM.

Tools for increasing visual encounter probabilities for invasive species removal: a case study of brown treesnakes

Early detection and rapid response (EDRR) are essential to identifying and decisively responding to the introduction or spread of an invasive species, thus avoiding population establishment and improving the probability of achieving eradication. However, detection can be challenging at the onset of a species invasion as low population densities can reduce the likelihood of detection and conceal the true extent of the situation until the species is well established. This is doubly challenging if the invading species displays cryptic behavior or is nocturnal, thus further limiting opportunities for its discovery. Survey methods that maximize a searcher’s ability to detect an incipient population are therefore critical for successful EDRR. Brown treesnakes (Boiga irregularis) on Guåhan are a classic cautionary example of the dangers of not detecting an invasion early on, and the risk of their introduction to other islands within the Marianas, Hawai’i and beyond remains. Nocturnal visual surveys are known to detect brown treesnakes of all sizes and are the primary detection tool used by the Brown Treesnake Rapid Response Team, but detection probability remains low in complex forest habitats. As such, we investigated the use of two potential enhancements to nocturnal visual surveys – a live mouse lure and spray scent attractant – that may create hotspots of increased detection probability during surveys. We found that, while brown treesnake detection probabilities were low for all surveys, visual surveys conducted on transects with live mouse lures resulted in detection probabilities that were 1.3 times higher than on transects without live mouse lures. Conversely, the spray scent attractant did not increase the probability of detecting brown treesnakes compared to transects without scent, and in fact had detection probabilities that were 0.66 times lower, though the reasons for this phenomenon are unclear. Unlike scent attractants, live mouse lures likely provide both visual and olfactory cues that attract brown treesnakes to transects and thus provide more opportunities to detect and capture them. These enhancements were trialed on Guåhan, where prey populations are depressed. It remains unclear whether live mouse lures will be as effective for EDRR applications in prey-rich settings.

Usability Evaluation of the Electronic Medical Record of the Rapid Response Team: a Case Study

Aim: This study was conducted to determine the usability of the rapid response team (RRT) electronic medical records (EMRs) system at an Abu-Ali-Sina organ transplant hospital, Shiraz, Iran. Method: This cross-sectional study was carried out in partnership with 25 direct members of RRT includes nurses and anesthesia technicians who were on the shift during the data collection for two months. To evaluate, the Questionnaire for User Interaction Satisfaction (QUIS) version 7 was used. Data were analyzed by SPSS version 19. Results: A total of 20 out of 25 questionnaires were obtained. Seven (25.0 %) of 27 sections were higher than seven, and all areas were higher than five. The highest rankings were for 1) reading characters on the computer screen 2) highlighting on the screen simplify task 3) overall reactions: wonderful and learning to operate the system. Conclusion: This study demonstrates the usability of the hospital RRT for the EMRs system and over the moderate. However, the flexibility and capability of the rapid response for EMRs tool require to be improved.