How RNs rescue patients: a qualitative study of RNs' perceived involvement in rapid response teams
How RNs rescue patients: a qualitative study of RNs' perceived involvement in rapid response teams
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DOI：
10.1136/qshc.2008.030494
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发表时间：
2010-10-01
影响因子：
--
通讯作者：
O'Rourke, Maria
中科院分区：
文献类型：
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作者：
Leach, Linda Searle;Mayo, Ann;O'Rourke, Maria
背景 每天都有患者入院，其临床状况可能会动态变化，从而导致不良后果。快速反应小组 (ART) 干预是一种正式资源，用于在代码逮捕发生之前回应护士对此类患者的担忧。注册护士 (RN) 能够识别关键变化并在最合适的时刻抢救患者，但人们对注册护士如何利用这些日益受欢迎的团队来抢救患者知之甚少。我们的目的是调查注册护士如何在设有 RRT 的医院中抢救患者。方法 50 名参与 RRT 的参与者在加州六家医院进行了半结构化个人访谈。使用编码和持续比较方法对数据进行分析。 结果 总体而言，RN 认为 RRT 是一种有用且有效的安全干预措施。 ART RN 和床边 RN 以协同方式相互支持，以防止抢救过程中发生不良患者事件。然而，传统的等级制度以及与医生和主管的关系阻碍了 RN 在救援过程中决策的某些组成部分。结论 RN 发现，当患者面临风险或护理需求发生变化时，RRT 会提供支持。他们受益于能够立即访问资源的正式机制。本研究中的 ART 注册护士运用他们在危重病人身上的专业知识来抢救内科和外科病人。 RAT RN 和床边 RN 的互动影响了抢救过程。他们的协同作用为注册护士预防不良事件和提高患者安全做出了增值贡献。
Background Patients are admitted to hospitals everyday with clinical conditions that can change dynamically resulting in adverse outcomes. The rapid response team (ART) intervention is a formalised resource to respond to the nurse's concerns about such patients before code arrest occurs. Registered nurses (RNs) are in a position to recognise critical changes and to rescue patients at the most opportune moments, but little is known about how RNs rescue patients using these increasingly popular teams. Our aims were to investigate how RNs rescue patients in hospitals where RRTs are in place.Methods Fifty participants involved with RRTs participated in semistructured individual interviews in six California hospitals. Data were analysed using coding and constant comparison methods.Results Overall, RNs view RRTs as a helpful and effective safety intervention. ART RNs and bedside RNs support one another in a synergistic way to prevent adverse patient events during the rescuing process. However, traditional hierarchies and relationships with physicians and supervisors impede some components of RN decision-making during rescuing.Conclusions RNs find the RRT supportive when their patient is at risk or care needs are changing. They benefit from a formalised mechanism that enables immediate access to resources. ART RNs in this study applied their expertise with critically ill patients to rescue medical and surgical patients. The RAT RN and bedside RNs' interaction influenced the rescuing process. Their role synergy was a value-added contribution to preventing adverse events and to improving patient safety by RNs.