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Pediatric Rapid Response Team

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https://www.readbyqxmd.com/read/28687637/inpatient-derived-vital-sign-parameters-implementation-an-initiative-to-decrease-alarm-burden
#1
Alaina K Kipps, Sarah F Poole, Cheryl Slaney, Shannon Feehan, Christopher A Longhurst, Paul J Sharek, Veena V Goel
OBJECTIVES: To implement data-driven vital sign parameters to reduce bedside monitor alarm burden. METHODS: Single-center, quality-improvement initiative with historical controls assessing the impact of age-based, inpatient-derived heart rate (HR) and respiratory rate (RR) parameters on a 20-bed acute care ward that serves primarily pediatric cardiology patients. The primary outcome was the number of alarms per monitored bed day (MBD) with the aim to decrease the alarms per MBD...
July 7, 2017: Pediatrics
https://www.readbyqxmd.com/read/28483067/simulation-testing-of-pediatric-rapid-response-teams-can-simulation-be-used-to-determine-the-best-team-structure
#2
EDITORIAL
David A Young
No abstract text is available yet for this article.
May 5, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28460698/when-nursing-assertion-stops-a-qualitative-study-to-examine-the-cultural-barriers-involved-in-escalation-of-care-in-a-pediatric-hospital
#3
REVIEW
Jodi Thrasher, Heidi McNeely, Bonnie Adrian
Pediatric codes outside the ICU are associated with increased morbidity and mortality. This qualitative research highlights results from confidential interviews with 10 pediatric nurses with experience of caring for children who required rapid response, code response, or transfer to intensive care. Detailed examination of nurses' experiences revealed local factors that facilitate and inhibit timely transfer of critical patients. Nurses identified themes including the impact of nurse assertiveness, providers' lack of understanding of nursing, team communication, and other hospital cultural barriers...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28456829/the-evolution-of-a-pediatric-ventricular-assist-device-program-the-boston-children-s-hospital-experience
#4
Beth Hawkins, Francis Fynn-Thompson, Kevin P Daly, Michelle Corf, Elizabeth Blume, Jean Connor, Courtney Porter, Christopher Almond, Christina VanderPluym
Mechanical circulatory support in the form of ventricular assist devices (VADs) in children has undergone rapid growth in the last decade. With expansion of device options available for larger children and adolescents, the field of outpatient VAD support has flourished, with many programs unprepared for the clinical, programmatic, and administrative responsibilities. From preimplantation VAD evaluation and patient education to postimplant VAD management, the VAD program, staffed with an interdisciplinary team, is essential to providing safe, effective, and sustainable care for a new technology in an exceedingly complex patient population...
April 29, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28445242/increased-mortality-and-length-of-stay-associated-with-medical-emergency-team-review-in-hospitalized-pediatric-patients-a-retrospective-cohort-study
#5
Brianna McKelvie, James Dayre McNally, Jason Chan, Franco Momoli, Christa Ramsay, Anna-Theresa Lobos
OBJECTIVE: Rapid response systems using medical emergency teams reduce hospital wide cardiorespiratory arrest and mortality. While rapid response systems improve hospital-wide outcomes, children receiving medical emergency team review may still be at increased risk for morbidity and mortality. The study purpose was to compare the length of stay and mortality rate in children receiving a medical emergency team review with those of other hospitalized children. DESIGN: Retrospective cohort study...
June 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28434554/the-simulation-based-assessment-of-pediatric-rapid-response-teams
#6
James J Fehr, Mary E McBride, John R Boulet, David J Murray
OBJECTIVE: To create scenarios of simulated decompensating pediatric patients to train pediatric rapid response teams (RRTs) and to determine whether the scenario scores provide a valid assessment of RRT performance with the hypothesis that RRTs led by intensivists-in-training would be better prepared to manage the scenarios than teams led by nurse practitioners. STUDY DESIGN: A set of 10 simulated scenarios was designed for the training and assessment of pediatric RRTs...
April 20, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#7
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28119369/improving-pediatric-rapid-response-team-performance-through-crew-resource-management-training-of-team-leaders
#8
Ashley Siems, Alexander Cartron, Anne Watson, Robert McCarter, Amanda Levin
BACKGROUND: Rapid response teams (RRTs) improve the detection of and response to deteriorating patients. Professional hierarchies and the multidisciplinary nature of RRTs hinder team performance. This study assessed whether an intervention involving crew resource management training of team leaders could improve team performance. METHODS: In situ observations of RRT activations were performed pre- and post-training intervention. Team performance and dynamics were measured by observed adherence to an ideal task list and by the Team Emergency Assessment Measure tool, respectively...
February 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/27850889/1253-implementation-of-a-formal-debriefing-program-after-pediatric-rapid-response-team-activations
#9
Linda Aponte-Patel, Arash Salavitabar, Pamela Fazzio, Andrew Geneslaw, Pamela Good, Anita Sen
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850782/1145-perceived-barriers-to-activation-of-the-pediatric-rapid-response-team-by-nurses-and-residents
#10
Theodore DeMartini, Adrian Zurca, Kaylee Hollern, Sean Zajdel, Sarah Comly, Lauren Cable, E Scott Halstead
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27706523/rapid-response-team-activations-in-pediatric-surgical-patients
#11
Shannon N Acker, Beth Wathen, Genie E Roosevelt, Lauren R S Hill, Anna Schubert, Jenny Reese, Denis D Bensard, Ann M Kulungowski
Introduction The rapid response team (RRT) is a multidisciplinary team who evaluates hospitalized patients for concerns of nonemergent clinical deterioration. RRT evaluations are mandatory for children whose Pediatric Early Warning System (PEWS) score (assessment of child's behavior, cardiovascular and respiratory status) is ≥4. We aimed to determine if there were differences in characteristics of RRT calls between children who were admitted primarily to either medical or surgical services. We hypothesized that RRT activations would be called for less severely ill children with lower PEWS score on surgical services compared with children admitted to a medical service...
February 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27575799/implementation-of-a-pediatric-early-warning-scoring-system-at-an-academic-medical-center
#12
Kimberly Douglas, Jerry Christopher Collado, Sheila Keller
Despite the addition of family-activated rapid response to the rapid response team algorithm, a children's hospital did not see an increase in utilization of the pediatric rapid response team. A Pediatric Early Warning Score in non-ICU pediatric inpatient units was implemented to increase the number of rapid response team activations. A retrospective review of the 130-bed facility, over a 12-month period, revealed an increase in pediatric rapid response calls, with a subsequent decrease in code team activations...
October 2016: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27497385/quality-improvement-utilizing-in-situ-simulation-for-a-dual-hospital-pediatric-code-response-team
#13
MULTICENTER STUDY
Phoebe Yager, Corey Collins, Carlene Blais, Kathy O'Connor, Patricia Donovan, Maureen Martinez, Brian Cummings, Christopher Hartnick, Natan Noviski
OBJECTIVE: Given the rarity of in-hospital pediatric emergency events, identification of gaps and inefficiencies in the code response can be difficult. In-situ, simulation-based medical education programs can identify unrecognized systems-based challenges. We hypothesized that developing an in-situ, simulation-based pediatric emergency response program would identify latent inefficiencies in a complex, dual-hospital pediatric code response system and allow rapid intervention testing to improve performance before implementation at an institutional level...
September 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27427880/a-more-rapid-rapid-response
#14
Justin Robison, Nicholas B Slamon
OBJECTIVES: Critical care physicians' standard for arrival to a rapid response team activation is 10 minutes or less at this institution. This study proposes that a FaceTime (Apple, Cupertino, CA) video call between the staff at the bedside and the critical care physician will allow the implementation of potentially life-saving therapies earlier than the current average response (4.5 min). DESIGN: Prospective cohort study. SETTING: Freestanding, tertiary-care children's hospital...
September 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27358574/safety-and-efficacy-of-nurse-controlled-analgesia-in-patients-less-than-1-year-of-age
#15
Hina Walia, Dmitry Tumin, Sharon Wrona, David Martin, Tarun Bhalla, Joseph D Tobias
BACKGROUND: The management of acute pain presents unique challenges in the younger pediatric population. Although patient-controlled devices are frequently used in patients ≥6 years of age, alternative modes of analgesic delivery are needed in infants. OBJECTIVE: To examine the safety and efficacy of nurse-controlled analgesia (NCA) in neonates less than 1 year of age. METHODS: Data from patients <1 year of age receiving NCA as ordered by the Acute Pain Service at our institution were collected over a 5-year period and reviewed retrospectively...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27258792/the-impact-of-implementation-of-family-initiated-escalation-of-care-for-the-deteriorating-patient-in-hospital-a-systematic-review
#16
REVIEW
Fenella J Gill, Gavin D Leslie, Andrea P Marshall
BACKGROUND: Rapid response systems incorporate concepts of early recognition of patient deterioration, prompt reporting, and response which result in escalation of patient care. The ability to initiate escalation of care is now being extended to families of hospitalized patients. RESEARCH AIMS: To identify the impact of implementation of family-initiated escalation of care for the deteriorating patient in hospital? METHODS: A systematic review of peer-reviewed publications was conducted...
August 2016: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/27043094/use-of-simulation-to-gauge-preparedness-for-ebola-at-a-free-standing-children-s-hospital
#17
Elizabeth A Biddell, Brian L Vandersall, Stephanie A Bailes, Stephanie A Estephan, Lori A Ferrara, Kristine M Nagy, Joyce L O'Connell, Mary D Patterson
On October 10, 2014, a health care worker exposed to Ebola traveled to Akron, OH, where she became symptomatic. The resulting local public health agencies and health care organization response was unequalled in our region. The day this information was announced, the emergency disaster response was activated at our hospital. The simulation center had 12 hours to prepare simulations to evaluate hospital preparedness should a patient screen positive for Ebola exposure. The team developed hybrid simulation scenarios using standardized patients, mannequin simulators, and task trainers to assess hospital preparedness in the emergency department, transport team, pediatric intensive care unit, and for interdepartmental transfers...
April 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/26972832/etiology-of-postanesthetic-and-postsedation-events-on-the-inpatient-ward-data-from-a-rapid-response-team-at-a-tertiary-care-children-s-hospital
#18
N'Diris Barry, Karen M Miller, Gregory Ryshen, Joshua Uffman, Thomas A Taghon, Joseph D Tobias
INTRODUCTION: The goal of this study was to identify the etiology of events and demographics of patients that experience complications requiring activation of the Rapid Response Team (RRT) during the first 24 h following anesthetic care. METHODS: We performed a retrospective review of the Quality Improvement database from the Department of Anesthesiology & Pain Medicine at Nationwide Children's Hospital. The database was searched to identify those patients who had a RRT evaluation activated within 24 h of receiving anesthesia or procedural sedation...
May 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/26724305/rapid-response-team-calls-and-unplanned-transfers-to-the-pediatric-intensive-care-unit-in-a-pediatric-hospital
#19
Stacey Humphreys, Balagangadhar R Totapally
BACKGROUND: Variability in disposition of children according to the time of rapid response calls is unknown. OBJECTIVE: To evaluate times and disposition of rapid response alerts and outcomes for children transferred from acute care to intensive care. METHODS: Deidentified data on demographics, time and disposition of the child after activation of a rapid response, time of transfer to intensive care, and patient outcomes were reviewed retrospectively...
January 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/26543462/the-rapid-response-team-in-outpatient-settings-identifies-patients-who-need-immediate-intensive-care-unit-admission-a-call-for-policy-maker
#20
Mariam A Alansari, Eyad A Althenayan, Mohammed H Hijazi, Khalid A Maghrabi
BACKGROUND: Caregivers in the ambulatory care setting with differing clinical background could encounter a patient at high risk of deterioration. In the absence of a dedicated acute care team, the response to an unanticipated medical emergencies in these settings is likely to have a poor outcome. OBJECTIVE: To describe our experience in implementing an intensivist-led rapid response team (RRT) in the outpatient settings that identified patients who needed immediate Intensive Care Unit (ICU) admission...
October 2015: Saudi Journal of Anaesthesia
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