Navigation Links
Triggers study evaluates regular staff, ICU specialists
Date:7/17/2012

BOSTON A system of care focused on the detection and systematic assessment of patients with clinical instability can yield similar outcomes as rapid response teams staffed with trained intensive care specialists, a Beth Israel Deaconess Medical Center study has found.

The analysis of 177,347 patients over a 59-month period was published online in Critical Care Medicine, the journal of the Society of Critical Care Medicine. Rapid Response Teams have become an important part of hospital care in recent years, sending critical care-trained responders to the bedside of decompensating patients. Most rapid response teams in the United States send a special ICU-based team of additional providers to the bedside of these patients.

"We found that a rapid response team that relied on providers already assigned to a patient's care, rather than a separate ICU-based rapid response team was associated with a marked reduction in the rate of unexpected mortality," says Michael D. Howell, MD, MPH, a critical care specialist at BIDMC and Assistant Professor of Medicine at Harvard Medical School.

BIDMC launched a novel model of a rapid response team, called Triggers, in 2005. This program differs from the usual rapid response team approach because it does not add additional clinical staff to the patient's care. Instead, it organizes the response of providers who were already assigned to the patient's care.

The Trigger team includes the patient's nurse, intern, respiratory therapist, and the floor's senior nurse all of whom respond to a patient's bedside when confronted with a number of diagnostic factors, such as heart rate, blood pressure, respiratory rater, oxygen saturation or urine output charge within set parameters. A "trigger" can also be called on the concern of the nurse caring for the patient or in recent years the team can be directly called by patients or family members who are worried.

If an initial evaluation warrants a follow-up, a resident and the senior attending physician must be notified.

In a study of cases from 2004 to 2008, researchers found that the Triggers program resulted in a 65 percent reduction in the odds of unexpected mortality among all patients admitted to the hospital. The risk of overall in-hospital mortality was 5 percent lower, but this was not a statistically significant difference.

Those findings are relevant to clinicians and policymakers for two reasons.

"Our lower-staffing intensity approach produces outcomes comparable with ICU-based approaches," Howell wrote. "This approach requires no additional clinical staffing, preserves provider continuity (which may limit adverse events and respects traditional tenets of medical education."

Given issues surrounding the shortage of intensivists, who are called upon to perform out-of-ICU duties, particularly in smaller hospitals "it may be that intensivists' time is better spent with the critically ill in the ICU rather than serving as part of a rapid response team."


'/>"/>

Contact: Jerry Berger
jberger@bidmc.harvard.edu
617-667-7308
Beth Israel Deaconess Medical Center
Source:Eurekalert

Related medicine news :

1. Chronic cocaine use triggers changes in brains neuron structure
2. Pleasure eating triggers bodys reward system and may stimulate overeating
3. Specific protein triggers changes in neurons in brain reward center linked to cocaine addiction
4. UCSB study reveals brain functions during visual searches
5. Japan Nuke Disaster Will Kill Up to 1,300 People Worldwide, Study Estimates
6. New Yorks Trans-Fat Ban Is Working: Study
7. Plastics Chemical in Dental Fillings Might Affect Childrens Behavior: Study
8. High Blood Pressure May Protect Some Frail Elderly: Study
9. UW study plays pivotal role in todays FDA approval of HIV prevention drug
10. Gene therapy treatment extends lives of mice with fatal disease, MU study finds
11. Child Abuse Rises When Economy Sags: Study
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... June 27, 2016 , ... ... professionals, announced today its affiliation with Tennessee Counseling Association. This new ... network of the Tennessee Counseling Association, adding exclusive benefits and promotional offers. , ...
(Date:6/26/2016)... ... June 27, 2016 , ... Quality metrics are proliferating in ... ways they remain in the eye of the beholder, according to experts who offered ... The American Journal of Managed Care. For the full issue, click here . ...
(Date:6/26/2016)... ... June 26, 2016 , ... Brent Kasmer, a legally blind and certified personal trainer ... through a fitness app. The fitness app plans to fix the two major problems leading ... a one size fits all type program , They don’t eliminate all the ...
(Date:6/25/2016)... ... 25, 2016 , ... The temporary closing of Bruton Memorial Library on June 21 due to ... a new, often overlooked aspect of head lice: the parasite’s ability to live away from ... common occurrence, but a necessary one in the event that lice have simply gotten out ...
(Date:6/25/2016)... ... June 25, 2016 , ... ... recover from injury. Recently, he has implemented orthobiologic procedures as a method for ... is one of the first doctors to perform the treatment. Orthobiologics are substances ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016   Pulmatrix, Inc ... company developing innovative inhaled drugs, announced today that it ... Russell Investments reconstituted its comprehensive set of U.S. ... "This is an important milestone for Pulmatrix," said ... increase shareholder awareness of our progress in developing drugs ...
(Date:6/23/2016)... June 23, 2016  MedSource announced today that ... e-clinical software solution of choice.  This latest decision ... value to their clients by offering a state-of-the-art ... relationship establishes nowEDC as the EDC platform of ... full-service clients.  "nowEDC has long been a preferred ...
(Date:6/23/2016)... -- Research and Markets has announced the ... (Organic Chemical (Sugar, Petrochemical, Glycerin), Inorganic Chemical), Functionality (Filler, ... Global Forecast to 2021" report to their offering. ... pharmaceutical excipients market is projected to reach USD 8.1 ... the forecast period 2016 to 2021. ...
Breaking Medicine Technology: