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Emergency care within hospitals: can it be done more efficiently? 2015

Marjon Borgert, and Astrid Goossens, and Rob Adams, and Jan Binnekade, and Dave Dongelmans
PhD Candidate, Department of Intensive Care Medicine, University of Amsterdam, Amsterdam, The Netherlands.

BACKGROUND Cardiac Arrest Teams (CATs) are frequently activated by nurses when patients experience 'false arrests' (FAs). In those cases activation of the Rapid Response Team (RRT) might be more efficient. The authors determined the level of urgency of FAs to find a scope for improvement in efficiency within emergency care. METHODS CAT-activations for FAs in a university hospital from September 2009 to 2012 were retrospectively analysed and classified as urgent or less-urgent. RESULTS In 26% (107/405) the CAT was activated for FAs. Calls were classified as urgent in 43% (46/107). Less urgent calls comprised 57% (61/107) of the FAs, difference 14% (95%CI: 1% to 26%). CONCLUSIONS A significant part of the CAT-activations for FAs were less urgent and an RRT-activation might be more efficient. To minimise the CAT-activations for FAs, nurses need to recognise early patients who clinically deteriorate. Therefore, nurses should use the Modified Early Warning Score correctly.

UI MeSH Term Description Entries
D009426 Netherlands Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, and Sint Maarten, formerly included in the NETHERLANDS ANTILLES. Holland,Kingdom of the Netherlands
D009730 Nursing Assessment Evaluation of the nature and extent of nursing problems presented by a patient for the purpose of patient care planning. Nursing Protocols,Assessment, Nursing,Protocols, Nursing,Assessments, Nursing,Nursing Assessments,Nursing Protocol,Protocol, Nursing
D006323 Heart Arrest Cessation of heart beat or MYOCARDIAL CONTRACTION. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation. Asystole,Cardiac Arrest,Cardiopulmonary Arrest,Arrest, Cardiac,Arrest, Cardiopulmonary,Arrest, Heart,Asystoles
D006785 Hospitals, University Hospitals maintained by a university for the teaching of medical students, postgraduate training programs, and clinical research. University Hospitals
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001049 Apnea A transient absence of spontaneous respiration. Apneas
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D015600 Glasgow Coma Scale A scale that assesses the response to stimuli in patients with craniocerebral injuries. The parameters are eye opening, motor response, and verbal response. Coma Scale, Glasgow,Scale, Glasgow Coma
D017598 Efficiency, Organizational The capacity of an organization, institution, or business to produce desired results with a minimum expenditure of energy, time, money, personnel, material, etc. Efficiency, Administrative,Productivity, Organizational,Program Efficiency,Administrative Efficiency,Organizational Productivity,Efficiency, Program,Organizational Efficiency,Program Efficiencies
D055986 Vital Signs The signs of life that may be monitored or measured, namely pulse rate, respiratory rate, body temperature, and blood pressure. Sign, Vital,Signs, Vital,Vital Sign

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