Characteristics of Pediatric Rapid Response Systems: Results From a Survey of PRIS Hospitals
| Autor: | Jennifer Reese, Beth Wathen, Sonja I. Ziniel, Christopher P. Bonafide, Sean T. O’Leary, Amanda F. Dempsey, Justin Lockwood, Patrick W. Brady |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Vital signs Physical examination Pediatrics 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Surveys and Questionnaires medicine Humans 030212 general & internal medicine Prospective Studies Medical diagnosis Rapid response team Prospective cohort study Child Response rate (survey) Team composition medicine.diagnostic_test business.industry General Medicine Early warning score Hospitals Hospitalization Pediatrics Perinatology and Child Health Emergency medicine business Hospital Rapid Response Team |
| Zdroj: | Hospital pediatrics. 11(2) |
| ISSN: | 2154-1671 |
| Popis: | BACKGROUND: Many hospitals use rapid response systems (RRSs) to identify and intervene on hospitalized children at risk for deterioration. OBJECTIVES: To describe RRS characteristics across hospitals in the Pediatric Research in Inpatient Settings (PRIS) network. METHODS: We developed the survey through a series of prospective respondent, expert, and cognitive interviews. One institutional expert per PRIS hospital (n = 109) was asked to complete the web survey. We summarized responses using descriptive statistics with a secondary analysis of univariate associations between RRS characteristics and perceived effectiveness. RESULTS: The response rate was 72% (79 of 109). Respondents represented diverse hospital types and were primarily physicians (97%) with leadership roles in care escalation. Many hospitals used an early warning score (77%) for identification with variable characteristics (46% automated versus 54% full or partially manual calculation; inputs included vital signs [98%], physical examination findings [88%], diagnoses [23%], medications [19%], and diagnostic tests [14%]). Few incorporated a validated prediction model (9%). Similarly, many RRSs used a rapid response team for intervention (93%) with variable team composition (respiratory therapists [94%], ICU nurses [93%], ICU providers [67%], and pharmacists [27%]). Some used the early warning score to trigger the rapid response team (50%). Only a few staffed a clinician to proactively surveil hospitalized children for risk of deterioration (18%), and these tended to be larger hospitals (annual admissions 12 000 vs 6000, P = .007). Most responding experts stated their RRSs improved patient outcomes (92%). CONCLUSIONS: RRS characteristics varied across PRIS hospitals. |
| Databáze: | OpenAIRE |
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