Critical care clinician perceptions of factors leading to Medical Emergency Team review
| Autor: | Daryl A Jones, Josh Allen, Judith Currey |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Health Knowledge Attitudes Practice media_common.quotation_subject education Emergency Nursing Critical Care Nursing 03 medical and health sciences 0302 clinical medicine Nursing Critical care nursing Intensive care Acute care Surveys and Questionnaires medicine Medical Staff Hospital Humans 030212 general & internal medicine Clinical Governance Hospital Mortality Rapid response team media_common Clinical governance Teamwork Terminal Care Clinical Deterioration business.industry 030208 emergency & critical care medicine Length of Stay medicine.disease Quality Improvement Intensive Care Units Female Medical emergency Patient Safety business End-of-life care Rapid response system Hospital Rapid Response Team |
| Zdroj: | Australian critical care : official journal of the Confederation of Australian Critical Care Nurses. 31(2) |
| ISSN: | 1036-7314 |
| Popis: | Background The introduction of rapid response systems has reduced the incidence of in-hospital cardiac arrest; however, many instances of clinical deterioration are unrecognised. Afferent limb failure is common and may be associated with unplanned intensive care admissions, heightened mortality and prolonged length of stay. Patients reviewed by a Medical Emergency Team are inherently vulnerable with a high in-hospital mortality. Objective To explore perceptions of intensive care unit (ICU) staff who attend deteriorating acute care ward patients regarding current problems, barriers and potential solutions to recognising and responding to clinical deterioration that culminates in a Medical Emergency Team review. Methods A descriptive exploratory design was used. Registered intensive care nurses and medical staff (N = 207) were recruited during a professional conference using purposive sampling for experience in attending deteriorating patients. Written response surveys were used to address the study aim. Data were analysed using content analysis. Results Four major themes were identified: Governance, Teamwork, Clinical Care Delivery and End of Life Care. Participants perceived there was a lack of sufficient and senior staff with the required theoretical knowledge; and inadequate assessment and critical thinking skills for anticipating, recognising and responding to clinical deterioration. Senior doctors were perceived to inappropriately manage End of Life Care issues and displayed Teamwork behaviours rendering ward clinicians feeling fearful and intimidated. A lack of System and Clinical Governance hindered identification of clinical deterioration. Conclusions To improve patient safety related to recognising and responding to clinical deterioration, suboptimal care due to professionals’ knowledge, skills and behaviours need addressing, along with End of Life Care and Governance. |
| Databáze: | OpenAIRE |
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