Defining impact of a rapid response team: qualitative study with nurses, physicians and hospital administrators
Defining impact of a rapid response team: qualitative study with nurses, physicians and hospital administrators
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DOI：
10.1136/bmjqs-2011-000390
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发表时间：
2012-05-01
影响因子：
5.4
通讯作者：
Horwitz, Leora I.
中科院分区：
文献类型：
--
作者：
Benin, Andrea L.;Borgstrom, Christopher P.;Horwitz, Leora I.
目的：本研究的目的是定性描述快速反应小组（RRT）在一个944个床位的大学附属医院的影响。方法：对49名管理人员、初级团队主治医师、实习生、RRT主治医师、护士长、护士和呼吸技术人员进行开放式访谈。结果：引出的主题分为(1)士气和团队合作，(2)教育，(3)工作量，(4)病人护理和(5)医院管理。除了改善对急症患者的护理外，积极的影响还包括：提高护士的士气和赋权，实时重新分配护士的工作量（减少紧急情况下对非急症患者的忽视），以及立即获得专家帮助。负面影响是：护士和医生团队之间的紧张关系加剧，医院医师RRT成员的负担加重，受训人员的自主权降低。结论：RRT提供的优势远远超出了减少转移到重症监护病房或代码的比率，但也有某些缺点。应评估这些多种来源的潜在影响，以了解任何RRT方案的效用。
Objective: The objective of this study was to qualitatively describe the impact of a Rapid Response Team (RRT) at a 944-bed, university-affiliated hospital.Methods: We analysed 49 open-ended interviews with administrators, primary team attending physicians, trainees, RRT attending hospitalists, staff nurses, nurses and respiratory technicians.Results: Themes elicited were categorised into the domains of (1) morale and teamwork, (2) education, (3) workload, (4) patient care, and (5) hospital administration. Positive implications beyond improved care for acutely ill patients were: increased morale and empowerment among nurses, real-time redistribution of workload for nurses (reducing neglect of non-acutely ill patients during emergencies), and immediate access to expert help. Negative implications were: increased tensions between nurses and physician teams, a burden on hospitalist RRT members, and reduced autonomy for trainees.Conclusions: The RRT provides advantages that extend well beyond a reduction in rates of transfers to intensive care units or codes but are balanced by certain disadvantages. The potential impact from these multiple sources should be evaluated to understand the utility of any RRT programme.