Paediatric family activated rapid response interventions; qualitative systematic review
Shannon Cresham Fox1, Nicola Taylor1, Takawira C Marufu2
1Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.
Insights
Family-activated rapid response systems empower families to alert medical teams to deteriorating paediatric patients, improving patient safety and outcomes. These systems are crucial for family-integrated care and can be adapted globally.
Area of Science:
- Pediatric Healthcare
- Patient Safety
- Family-Integrated Care
Background:
- Failure to rescue, a leading cause of patient harm, occurs when patient deterioration is not recognized early.
- Families often notice changes in a child's condition before healthcare professionals.
- Family-activated rapid response systems are increasingly recognized to mitigate failure to rescue and promote early intervention.
Purpose of the Study:
- To identify current family-activated rapid response interventions for hospitalized pediatric patients.
- To understand the mechanisms through which family activation improves care.
Main Methods:
- A narrative systematic review of published studies was conducted.
- Searched seven online databases (AMED, CINHAL, EMBASE, EMCARE, HMIC, JBI, Medline).
- Assessed study rigor and validity using the Critical Appraisal Skills Programme tool.
Main Results:
- Six studies met inclusion criteria, identifying five telephone-based family activation interventions.
- These interventions grant families a process to escalate concerns to hospital emergency teams.
- Key outcomes include enhanced patient safety, family empowerment, partnership working, effective communication, and improved patient outcomes.
- A notable limitation was the lack of multi-lingual options in identified interventions.
Conclusions:
- Family-activated rapid response systems are fundamental to family-integrated care and patient safety.
- The principles and concepts of these interventions are transferable across global healthcare systems.
Background:
Failure to recognise deterioration early which results in patient death, is considered failure to rescue and it is identified as one of the leading causes of harm to patients. It is recognised that patients and their families can often recognise changes within the child's condition before healthcare professionals. To mitigate the risk of failure to rescue and promote early intervention, family-activated rapid response systems are becoming widely acknowledged and accepted as part of family integrated care.
Objective:
To identify current family-activated rapid response interventions in hospitalised paediatric patients and understand mechanisms by which family activation works.
Methods:
A narrative systematic review of published studies was conducted. Seven online databases; AMED, CINHAL, EMBASE, EMCARE, HMIC, JBI, and Medline were searched for potentially relevant papers. The critical appraisal skills programme tool was used to assess methodological rigor and validity of included studies.
Results:
Six studies met the predefined inclusion criteria. Five telephone family activation interventions were identified; Call for Help, medical emergency-teams, Condition HELP, rapid response teams, and family initiated rapid response. Principles underpinning all interventions were founded on a principal of granting families access to a process to escalate concerns to hospital emergency teams. Identified interventions outcomes and mechanisms include; patient safety, empowerment of families, partnership working/ family centred care, effective communication and better patient outcomes. Interventions lacked multi-lingual options.
Conclusion:
Family activation rapid response system are fundamental to family integrated care and enhancing patient safety. Underlying principles and concepts in delivering interventions are transferable across global healthcare system.
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