Attitudes and barriers to a Medical Emergency Team system at a tertiary paediatric hospital
Attitudes and barriers to a Medical Emergency Team system at a tertiary paediatric hospital
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DOI：
10.1016/j.resuscitation.2010.10.013
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发表时间：
2011-02-01
期刊：
影响因子：
6.5
通讯作者：
Tibballs, James
中科院分区：
文献类型：
--
作者：
Azzopardi, Peter;Kinney, Sharon;Tibballs, James
目的：确定的态度和障碍，建立儿科医疗急救队（MET）系统之间的护士和医生。方法：邀请所有临床工作人员在儿科医院完成一个电子41项分支调查。回应进行了分级的Likert量表。结果：407名工作人员完成了调查（280名护士，127名医生）。85%的护士和83%的医生认为MET系统能为重症患者提供紧急援助。然而，MET激活的障碍包括：80%的护士和45%的医生倾向于联系覆盖（主治）医生，41%的护士和12%的医生积极劝阻激活MET，17%的护士和9%的医生害怕批评，如果MET与会者认为患者病情不严重。经验不足的工作人员更有可能报告呼叫MET的障碍。护士（24%）和医生（6.5%）报告了MET与会者的负面态度。47%的医生和32%的护士在达到激活标准时不愿意激活MET，30%的医生和15%的护士回顾性地意识到他们在需要时没有激活MET，这表明他们没有认识到严重的疾病。MET激活的文化和行为障碍以及无法识别严重疾病可能部分解释了MET系统未能完全消除意外心脏事件的原因。逮捕和死亡。除非这些问题得到解决，否则MET系统的全部好处可能无法实现。(C)2010爱思唯尔爱尔兰有限公司版权所有。
Aim: To determine the attitudes and barriers to an established paediatric Medical Emergency Team (MET) system among nurses and doctors.Methods: Invitation to all clinical staff in a paediatric hospital to complete an electronic 41-item branched survey. Responses were graded on a Likert scale.Results: 407 staff completed the survey (280 nurses, 127 doctors). The MET system was highly valued for obtaining urgent assistance for the seriously ill patients by 85% of nurses and 83% of doctors. However, barriers to MET activation included; preference to contact the covering (attending) doctors by 80% of nurses and 45% of doctors, active discouragement to activating a MET by 41% of nurses and 12% of doctors, and fear of criticism by 17% of nurses and 9% of doctors if the patient was not deemed seriously ill by the MET attendees. Less experienced staff were significantly more likely to report barriers to calling a MET. Negative attitudes from MET attendees were reported by nurses (24%) and doctors (6.5%). Failure to recognize serious illness was revealed by unwillingness of 47% of doctors and 32% of nurses to activate MET when activation criteria were attained and by retrospective realization by 30% of doctors and 15% of nurses that they had failed to activate MET when needed.Conclusions: Cultural and behavioral barriers to MET activation and inability to recognize serious illness may explain in part the failure of a MET system to completely eliminate unexpected cardiac arrest and death. Unless these issues are addressed, the full benefits of a MET system may not be realised. (C) 2010 Elsevier Ireland Ltd. All rights reserved.