National Survey : How Do We Approach the Patient at Risk of Clinical Deterioration outside the ICU in the Spanish Context?
Clemente Vivancos, Álvaro (Institut Hospital del Mar d'Investigacions Mèdiques)
León Castelao, Esther (Universitat de Barcelona)
Castellanos-Ortega, Álvaro (Universitat de València)
Bodí, María (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Gordo Vidal, Federico (Universidad Francisco de Vitoria)
Martin Delgado, Maria Cruz (Universidad Francisco de Vitoria)
Jorge-Soto, Cristina (Universidade de Santiago de Compostela)
Fernandez Mendez, Felipe (Universidade de Vigo)
Igeño Cano, Jose Carlos (Hospital San Juan de Dios (Córdoba))
Trenado Álvarez, José (Universitat de Barcelona. Departament de Medicina)
Caballero, Jesús (Institut de Recerca Biomèdica de Lleida)
Parraga Ramirez, Manuel Jose (Medical Degree Direction Team (Múrcia))
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Background: Anticipating and avoiding preventable intrahospital cardiac arrest and clinical deterioration are important priorities for international healthcare systems and institutions. One of the internationally followed strategies to improve this matter is the introduction of the Rapid Response Systems (RRS). Although there is vast evidence from the international community, the evidence reported in a Spanish context is scarce. Methods: A nationwide cross-sectional research consisting of a voluntary 31-question online survey was performed. The Spanish Society of Intensive, Critical and Coronary Care Medicine (SEMICYUC) supported the research. Results: We received 62 fully completed surveys distributed within 13 of the 17 regions and two autonomous cities of Spain. Thirty-two of the participants had an established Rapid Response Team (RRT). Common frequency on measuring vital signs was at least once per shift but other frequencies were contemplated (48. 4%), usually based on professional criteria (69. 4%), as only 12 (19. 4%) centers used Early Warning Scores (EWS) or automated alarms on abnormal parameters. In the sample, doctors, nurses (55%), and other healthcare professionals (39%) could activate the RRT via telephone, but only 11. 3% of the sample enacted this at early signs of deterioration. The responders on the RRT are the Intensive Care Unit (ICU), doctors, and nurses, who are available 24/7 most of the time. Concerning the education and training of general ward staff and RRT members, this varies from basic to advanced and specific-specialized level, simulating a growing educational methodology among participants. A great number of participants have emergency resuscitation equipment (drugs, airway adjuncts, and defibrillators) in their general wards. In terms of quality improvement, only half of the sample registered RRT activity indicators. In terms of the use of communication and teamwork techniques, the most used is clinical debriefing in 29 centers. Conclusions: In terms of the concept of RRS, we found in our context that we are in the early stages of the establishment process, as it is not yet a generalized concept in most of our hospitals. The centers that have it are in still in the process of maturing the system and adapting themselves to our context.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Rapid response team ; Hospital medical emergency team ; Early warning score
Publicat a:	International journal of environmental research and public health, Vol. 19 (october 2022) , ISSN 1660-4601

DOI: 10.3390/ijerph191912627
PMID: 36231926

12 p, 367.2 KB

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