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Critical Care, Outreach, Cardiac Arrest,

N Alam, E L Hobbelink, A J van Tienhoven, P M van de Ven, E P Jansma, P W B Nanayakkara
BACKGROUND: Acute deterioration in critical ill patients is often preceded by changes in physiological parameters, such as pulse, blood pressure, temperature and respiratory rate. If these changes in the patient's vital parameters are recognized early, excess mortality and serious adverse events (SAEs) such as cardiac arrest may be prevented. The Early Warning Score (EWS) is a scoring system which assists with the detection of physiological changes and may help identify patients at risk of further deterioration...
May 2014: Resuscitation
D A Story, A Shelton, D Jones, M Heland, R Belomo
Co-management and critical care outreach for high risk surgical patients have been proposed to decrease postoperative complications and mortality. We proposed that a clinical project with postoperative comanagement and critical care outreach, the Post Operative Surveillance Team: (POST), would be associated with decreased hospital length of stay. We conducted a retrospective before (control group) and after (POST group) audit of this hospital program. POST was staffed for four months in 2010 by two intensive care nurses and two senior registrars who conducted daily ward rounds for the first five postoperative days on high risk patients undergoing inpatient general or urological surgery...
November 2013: Anaesthesia and Intensive Care
G McNeill, D Bryden
BACKGROUND: For critical care to be effective it must have a system in place to achieve optimal care for the deteriorating ward patient. OBJECTIVES: To systematically review the available literature to assess whether either early warning systems or emergency response teams improve hospital survival. In the event of there being a lack of evidence regarding hospital survival, secondary outcome measures were considered (unplanned ICU admissions, ICU mortality, length of ICU stay, length of hospital stay, cardiac arrest rates)...
December 2013: Resuscitation
Mandy Odell, Karin Gerber, Melanie Gager
Patients can experience unexpected deterioration in their physiological condition that can lead to critical illness, cardiac arrest, admission to the intensive care unit and death. While ward staff can identify deterioration through monitoring physiological signs, these signs can be missed, interpreted incorrectly or mismanaged. Rapid response systems using early warning scores can fail if staff do not follow protocols or do not notice or manage deterioration adequately. Nurses often notice deterioration intuitively because of their knowledge of individual patients...
December 9, 2010: British Journal of Nursing: BJN
A Moon, J F Cosgrove, D Lea, A Fairs, D M Cressey
AIMS: To determine whether cardiac arrest calls, the proportion of adult patients admitted to intensive care after CPR and their associated mortalities were reduced, in a four year period after the introduction of a 24/7 Critical Care Outreach Service and MEWS (Modified Early Warning System) Charts. METHODS: A retrospective analysis of prospectively collected data during two four-year periods, (2002-05 and 2006-09) in a UK University Teaching Hospital Comparisons were via χ(2) test...
February 2011: Resuscitation
Alison M Pirret
Research measuring the effectiveness of critical care outreach (CCOR) has been mixed. The objective of this paper is to describe the role and effectiveness of a nurse practitioner (NP) led critical care outreach service (CCORS). Using a comparative study design, data on the number of intensive care unit (ICU) readmissions <72h were analysed 12 months prior to, and 12 months following implementation of the service. Data was also collected on length of stay and APACHE II scores of ICU readmissions <72h, ICU patient acuity, ICU readmission mortality, and ward medical emergency team (MET) and cardiac arrest calls...
December 2008: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
J McGaughey, F Alderdice, R Fowler, A Kapila, A Mayhew, M Moutray
BACKGROUND: Despite the fact that outreach and early warning systems (EWS) are an integral part of a hospital wide systems approach to improve the early identification and management of deteriorating patients on general hospital wards, the widespread implementation of these interventions in practice is not based on robust research evidence. OBJECTIVES: The primary objective was to determine the impact of critical care outreach services on hospital mortality rates...
2007: Cochrane Database of Systematic Reviews
A Aneman, M Parr
BACKGROUND: A high incidence of preventable adverse events and deaths in hospitals has triggered initiatives to improve the quality of care of acutely ill in-hospital patients. System changes involving the introduction of medical emergency teams, outreach services or rapid response teams are an integral part of these initiatives. The rationale for implementing a designated team is that early recognition and rapid institution of adequate therapy for the deteriorating patient can improve outcome...
November 2006: Acta Anaesthesiologica Scandinavica
Lisa Esmonde, Ann McDonnell, Carol Ball, Catherine Waskett, Richard Morgan, Arash Rashidian, Kate Bray, Sheila Adam, Sheila Harvey
OBJECTIVE: We explored the impact of critical care outreach activity on patient and service outcomes and aimed to contribute to developing a typology of critical care outreach services. DESIGN: Following a sample search of Medline 15 relevant electronic databases were systematically searched from 1996 to 2004. Searches for publications from nine key authors and citations of eight key articles were performed. Hand searches of journals, bibliographies of reports and review articles, and conference abstracts were conducted...
November 2006: Intensive Care Medicine
Theresa Jacques, Gordon A Harrison, Mary-Louise McLaws, Gabrielle Kilborn
BACKGROUND: Emergency response systems (ERS) are based on a set of triggers used to identify patients "at risk". This study aimed to establish the association between recordings of disturbed physiological variables and adverse events. METHODS: A cross-sectional survey of 3,046 non Do Not Attempt Resuscitation (non DNAR) adult admissions in five hospitals over 14 days. Medical records were reviewed for 26 early signs (ES) and 21 late signs (LS) of critical conditions and serious adverse events (SAE): death, cardiac arrest, severe respiratory problems, or transfer to a critical care area...
May 2006: Resuscitation
Wayne P Robson
It is now 2 years since the publication of Department of Health [Comprehensive Critical Care: A Review of Adult Critical Care Services (2000a)] document 'Comprehensive Critical Care'. One of its' main recommendations was the introduction of critical care outreach services. Many hospitals have since established such services and are providing education for ward nurses and house officers, and follow-up for patients discharged from intensive care when they return to a general ward. Early Warning Scoring (EWS) systems have also been introduced onto the wards to improve the identification of patients deteriorating into critical illness...
August 2002: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
N Fox, J Rivers
No abstract text is available yet for this article.
August 2, 2001: Nursing Times
F McArthur-Rouse
AIM: The aim of this paper is to explore the literature relating to critical care outreach services and the use of early warning scoring systems to detect developing critical illness. BACKGROUND: Several studies have identified how suboptimal care may contribute to physiological deterioration of patients with major consequences on morbidity, mortality and requirement for intensive care. In a review of adult critical care services, the Department of Health (DOH) (England) recommended in 2000 that outreach services be established to avert admissions to Intensive Care, to enable discharges and to share critical care skills...
December 2001: Journal of Advanced Nursing
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