First of all, wanted to see how many of you have programs like this already set up in your facility. Do you like it and do you see improvement with it?
I will be going into specifics about this over the next few days once I get an idea of what is being done where you are. Included will be teaching about it and what it is, and what you can do to start a program in your country.
This will be our first project, and is actually a goal for 2008 for JCAHO here in the US to have this set up in every hospital throughout the country.
We have so called "resuscitation team" in our hospital (350-400 beds). They are 3-4 ICU RNs and doctors that are even in charge at the various wards at the moment : ICU, CCU and so on. At the moment that they receave call messeg on the pager they run to the ward that call their. In every chift there are different people in the team.
I work in a tertiary hospital in Melbourne, Australia. We introduced a Medical Emergency Team (MET) about four and a half years ago, modified October 2004, and I've noticed a huge decrease in Code Blues and vastly improved patient outcomes.
The parameters for a MET call are issued with staff ID and posted prominently - I'm writing this at work and staring straight at one:
- threatened airway
- resp rate >36 or
- SaO2
- SBP
- heart rate 140
- a fall in GCS of more than 2
- a prolonged seizure (usually 2 minutes or more)
- uncontrolled pain
- any serious concern about a patient
MET calls are attended by the parent unit, medical registrar, ICU registrar, ICU nurse and (out of hours) the clinical coordinator of the hospital.
When first introduced there was a tendency from ICU to question why a MET call was instigated if the patient was fine when they arrived (like following a vasovagal, for example). A review six months after the MET calls were introduced showed a number of patients meeting the criteria weren't MET called, and it's heavily reinforced that when in doubt initiated a MET call.
Patients MET call and resus status is well documented and handed over every shift change. I think they're brilliant!
I feel the the RRT (Rapid Response Team) is a very important initiative in my small hospital of 250 beds.
Us too, we have a card attached to our badge holders with specifics on when to call RRT. We recently hired a lots of new nurses who are uncertain on when to worry and this is a great guide for them. Our nurse educator teaches nurse that your are better call RRT when in doubt, I agree.
For me, in my ICU, it makes my work much easier so we can "try to fix" before the damage is done!!!
The only drawback is depending on the House Officer of the Night (the doctor covering the emergencies for the hospital), the doctor does not deal with treating the patient on the floor and bring the patient in the ICU using the last bed that we were keeping in case of a code in house.
Sometimes, giving a little oxygen, nitro SL or Lasix would fix everything!
Specializes in CV/CCU, Education,Stepdown cardiac, Tele.
Thanks Connyrn- sounds like you are working at the same place I am. At least I am on the same page with your educator for I am doing the same with out instittuion. I am telling them when in doubt to call and have also designed a badge for the primary RN with the criteria otherwise for calling.
In my ICU setting we are always in a bed crunch - we are just waiting for hospitalists to get contracted- untill then it is just RT and the ICU RN along with the primary RN who is part of the RRT.
They were implemented to try and reduce the number of cardiac arrests, because as everyone knows once people have arrested their mortality rate is very high,even if they survive the arrest initially. Idea was also to keep patients out of ICU due to a national shortage of beds.
Wards can refer patients who meet the criteria (maybe using the MEWS score) and the team (made up of Critical care nurses and medics) will do 3-4 rounds a day visiting the wards seeing referred patients.
At out trust we developed ALERT training specifically aimed at the healthcare assistants to train them in using the NEWS score when they are doing observations.This is lead by the Clinical lecturer Practitioners and might be modified according to the area that the healthcare assistants work in eg elderly patients,acute stroke,gastro etc
dan_haifa
33 Posts
We have so called "resuscitation team" in our hospital (350-400 beds). They are 3-4 ICU RNs and doctors that are even in charge at the various wards at the moment : ICU, CCU and so on. At the moment that they receave call messeg on the pager they run to the ward that call their. In every chift there are different people in the team.