National Survey: How Do We Approach the Patient at Risk of Clinical Deterioration outside the ICU in the Spanish Context?

Álvaro Clemente Vivancos, Esther León Castelao (), Álvaro Castellanos Ortega, Maria Bodi Saera, Federico Gordo Vidal, Maria Cruz Martin Delgado, Cristina Jorge-Soto, Felipe Fernandez Mendez, Jose Carlos Igeño Cano, Josep Trenado Alvarez, Jesus Caballero Lopez and Manuel Jose Parraga Ramirez
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Álvaro Clemente Vivancos: Health Sciences Doctoral Program, Universidad Católica de Murcia (UCAM), 30107 Murcia, Spain
Esther León Castelao: Simulation Laboratory, School of Medicine and Health Sciences, 08036 Barcelona, Spain
Álvaro Castellanos Ortega: Intensive Care Unit Medical Director, University Hospital La Fe, 46026 Valencia, Spain
Maria Bodi Saera: Intensive Care Unit, University Hospital Joan XIII, 43005 Tarragona, Spain
Federico Gordo Vidal: Intensive Care Unit, University Hospital of Henares, 28822 Madrid, Spain
Maria Cruz Martin Delgado: Intensive Care Unit, Hospital 12th of October, 28041 Madrid, Spain
Cristina Jorge-Soto: CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Universidad de Santiago de Compostela, 15705 Galicia, Spain
Felipe Fernandez Mendez: School of Nursing, Universidade de Vigo, 36310 Pontevedra, Spain
Jose Carlos Igeño Cano: Intensive Care Unit, San Juan de Dios Hospital, 14012 Cordoba, Spain
Josep Trenado Alvarez: Intensive Care and High Dependency Unit, Mutua Terrassa Hospital, 08221 Terrasa, Spain
Jesus Caballero Lopez: Intensive Care Unit, University Hospital Arnau de Vilanova, 25198 Lleida, Spain
Manuel Jose Parraga Ramirez: Intensive Care Unit, JM Morales Meseguer, 30008 Murcia, Spain

IJERPH, 2022, vol. 19, issue 19, 1-12

Abstract: Background: Anticipating and avoiding preventable intrahospital cardiac arrest and clinical deterioration are important priorities for international healthcare systems and institutions. One of the internationally followed strategies to improve this matter is the introduction of the Rapid Response Systems (RRS). Although there is vast evidence from the international community, the evidence reported in a Spanish context is scarce. Methods: A nationwide cross-sectional research consisting of a voluntary 31-question online survey was performed. The Spanish Society of Intensive, Critical and Coronary Care Medicine (SEMICYUC) supported the research. Results: We received 62 fully completed surveys distributed within 13 of the 17 regions and two autonomous cities of Spain. Thirty-two of the participants had an established Rapid Response Team (RRT). Common frequency on measuring vital signs was at least once per shift but other frequencies were contemplated (48.4%), usually based on professional criteria (69.4%), as only 12 (19.4%) centers used Early Warning Scores (EWS) or automated alarms on abnormal parameters. In the sample, doctors, nurses (55%), and other healthcare professionals (39%) could activate the RRT via telephone, but only 11.3% of the sample enacted this at early signs of deterioration. The responders on the RRT are the Intensive Care Unit (ICU), doctors, and nurses, who are available 24/7 most of the time. Concerning the education and training of general ward staff and RRT members, this varies from basic to advanced and specific-specialized level, simulating a growing educational methodology among participants. A great number of participants have emergency resuscitation equipment (drugs, airway adjuncts, and defibrillators) in their general wards. In terms of quality improvement, only half of the sample registered RRT activity indicators. In terms of the use of communication and teamwork techniques, the most used is clinical debriefing in 29 centers. Conclusions: In terms of the concept of RRS, we found in our context that we are in the early stages of the establishment process, as it is not yet a generalized concept in most of our hospitals. The centers that have it are in still in the process of maturing the system and adapting themselves to our context.

Keywords: rapid response team; hospital medical emergency team; early warning score (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
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