Factors influencing the activation of the rapid response system for clinically deteriorating patients by frontline ward clinicians: a systematic review.
Factors influencing the activation of the rapid response system for clinically deteriorating patients by frontline ward clinicians: a systematic review.
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DOI：
10.1093/intqhc/mzx149
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发表时间：
2017-12-01
期刊：
影响因子：
--
通讯作者：
Liaw SY
中科院分区：
文献类型：
--
作者：
Chua WL;See MTA;Legio-Quigley H;Jones D;Tee A;Liaw SY
综合病房护士和低年资医师快速反应系统（RRS）激活的影响因素及RRS激活不佳的原因。除了手动检索参考文献列表和相关期刊外，还检索了9个电子数据库中1995年1月至2016年1月期间发表的文章。在成人普通病房环境中进行的已发表的主要研究，涉及病房护士和/或初级医生在RRS激活方面的经验和观点。有关设计、方法和关键发现的数据被提取和整理。本次审查纳入了30项研究。RRS激活的过程受到病房护士和医生的看法和临床经验的影响，并通过工具和技术，包括激活标准的敏感性和特异性，以及监测技术来促进。然而，由于要寻求进一步的理由、审议快速反应小组的反应以及工作量和人员配置的影响，启动RRS系统的任务面临挑战。最后，坚持传统的护理升级模式，同事和医院领导的支持，以及员工培训是影响RRS激活的组织因素。这篇综述表明，影响RRS激活的因素来自社会文化，组织和技术方面的结合。努力改进现有RRS或正在考虑采用RRS的机构应考虑医疗环境中人与技术，任务，环境和组织元素之间的复杂相互作用。
To synthesize factors influencing the activation of the rapid response system (RRS) and reasons for suboptimal RRS activation by ward nurses and junior physicians. Nine electronic databases were searched for articles published between January 1995 and January 2016 in addition to a hand-search of reference lists and relevant journals. Published primary studies conducted in adult general ward settings and involved the experiences and views of ward nurses and/or junior physicians in RRS activation were included. Data on design, methods and key findings were extracted and collated. Thirty studies were included for the review. The process to RRS activation was influenced by the perceptions and clinical experiences of ward nurses and physicians, and facilitated by tools and technologies, including the sensitivity and specificity of the activation criteria, and monitoring technology. However, the task of enacting the RRS activations was challenged by seeking further justification, deliberating over reactions from the rapid response team and the impact of workload and staffing. Finally, adherence to the traditional model of escalation of care, support from colleagues and hospital leaders, and staff training were organizational factors that influence RRS activation. This review suggests that the factors influencing RRS activation originated from a combination of socio-cultural, organizational and technical aspects. Institutions that strive for improvements in the existing RRS or are considering to adopt the RRS should consider the complex interactions between people and the elements of technologies, tasks, environment and organization in healthcare settings.
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影响因子：
4.2
作者：
Cooper, Simon;Cant, Robyn;Sparkes, Louise
通讯作者：
Sparkes, Louise
影响因子：
8.1
作者：
Cioffi, J
通讯作者：
Cioffi, J
影响因子：
3.2
作者：
Carayon, Pascale;Wetterneck, Tosha B.;Gurses, Ayse P.
通讯作者：
Gurses, Ayse P.
影响因子：
5.4
作者：
Benin, Andrea L.;Borgstrom, Christopher P.;Horwitz, Leora I.
通讯作者：
Horwitz, Leora I.
影响因子：
8.8
作者：
Boniatti, Marcio M.;Azzolini, Neusa;Rodrigues Filho, Edison M.
通讯作者：
Rodrigues Filho, Edison M.