The use of medical emergency teams in medical and surgical patients: impact of patient, nurse and organisational characteristics.
Medical emergency teams (METs) were developed to respond more rapidly to changes in patient condition. While effective, METs do not address events prior to the response. This study examined differences in patient, nurse, and organisational characteristics for 108 MET calls on five medical and five surgical units in a university hospital. MET calls occurred more often on the day shift (p = 0.007) for medical (p = 0.036), but not surgical, patients. Of the 108 events, 44% were delayed, defined as events with documented evidence that pre-established criteria for a MET call were present for >30 min. More delays occurred on the night shift (p = 0.012). Delayed events were not related to the number of patients assigned (p = 0.608). However, there was a trend for more delays when more patients were assigned (4:1 = 21% vs 6:1 = 43%). In a logistic regression model, shift and patient-unit-match (medical, surgical) were significant predictors of delays. The model correctly predicted 68% of delayed events. Study findings indicate that a combination of patient, nurse and organisational characteristics influence timely rescue.
Bon Secours Health System, 1505 Marriottsville Road, Marriottsville, MD 21104, USA. andrea_schmid-mazzoccoli@bshsi.org
A
A
Schmid-Mazzoccoli
L A
LA
Hoffman
G A
GA
Wolf
M B
MB
Happ
M A
MA
Devita
D002637:Chest Pain / Q000628:therapy; D004417:Dyspnea / Q000628:therapy; D004630:Emergencies / Q000451:nursing; D004635:Emergency Medicine / Q000458:organization & administration*; D006757:Hospital Units; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration*; D012189:Retrospective Studies; D013503:Surgery Department, Hospital; D013997:Time Factors; D016896:Treatment Outcome