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Related Experiment Video

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A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
04:46

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Published on: January 17, 2011

Rescue me: saving the vulnerable non-ICU patient population.

Mary Kay Bader1, Beverly Neal, Linda Johnson

  • 1Mission Hospital, Mission Viego, California, USA. Badermk@aol.com

Joint Commission Journal on Quality and Patient Safety
|May 14, 2009
PubMed
Summary

A specialized nurse-driven rapid response team (RRT) significantly reduced non-intensive care unit (ICU) arrests and mortality. This initiative improved patient outcomes and optimized hospital resource allocation, demonstrating a commitment to vulnerable patient populations.

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Area of Science:

  • Hospital quality improvement
  • Patient safety initiatives
  • Critical care nursing

Background:

  • Pre-implementation review revealed significant deficits in non-ICU patient care, with 75% experiencing arrest due to knowledge/judgment issues.
  • Nearly half of all arrests occurred outside the ICU, resulting in a 60% mortality rate.
  • High monthly transfer rates (96 patients) from floor units to the ICU were observed.

Purpose of the Study:

  • To reduce the incidence and mortality of non-ICU arrests.
  • To decrease unplanned ICU transfers from floor units.
  • To provide critical care nursing for high-risk emergency department patients.

Main Methods:

  • A multidisciplinary team developed a nurse-driven rapid response team (RRT) protocol and data collection system over 12 months.
  • 4.2 FTE RRT nurse positions were established through unit contributions.
  • The RRT implemented a structured methodology for patient assessments and interventions.

Main Results:

  • Floor codes decreased from 36 to 17 per year, with a mortality rate drop from 61% to 26%.
  • RRT calls averaged 118 per 1,000 discharges, with 138 calls monthly supporting the ED.
  • Significant reduction in unanticipated floor-to-ICU transfers was achieved.

Conclusions:

  • The RRT initiative demonstrated measurable success in protecting vulnerable hospitalized patients.
  • The program facilitated the identification of system and clinical issues, leading to process improvements.
  • At-risk patient subpopulations, such as those with heart failure or on high-dose narcotics, were identified for targeted care.