Performance of patient acuity rating by rapid response team nurses for predicting short-term prognosis


Autoři: Hyung-Jun Kim aff001;  Hyun-Ju Min aff002;  Dong-Seon Lee aff003;  Yun-Young Choi aff003;  Miae Yoon aff003;  Da-Yun Lee aff003;  In-ae Song aff004;  Jun Yeun Cho aff002;  Jong Sun Park aff001;  Young-Jae Cho aff001;  You-Hwan Jo aff005;  Ho Il Yoon aff001;  Jae Ho Lee aff001;  Choon-Taek Lee aff001;  Yeon Joo Lee aff001
Působiště autorů: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea aff001;  Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea aff002;  Department of Nursing, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea aff003;  Department of Anesthesiology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea aff004;  Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea aff005
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225229

Souhrn

Background

Although scoring and machine learning methods have been developed to predict patient deterioration, bedside assessment by nurses should not be overlooked. This study aimed to evaluate the performance of subjective bedside assessment of the patient by the rapid response team (RRT) nurses in predicting short-term patient deterioration.

Methods

Patients noticed by RRT nurses based on the vital sign instability, abnormal laboratory results, and direct contact via phone between November 1, 2016, and December 12, 2017, were included. Five RRT nurses visited the patients according to their shifts and assessed the possibility of patient deterioration. Patient acuity rating (PAR), a scale of 1–7, was used as the tool of bedside assessment. Other scores, including the modified early warning score, VitalPAC early warning score, standardised early warning score, and cardiac arrest risk triage, were calculated afterwards. The performance of these scores in predicting mortality and/or intensive care unit admission within 1 day was compared by calculating the area under the receiver operating curve.

Results

A total of 1,426 patients were included in the study, of which 258 (18.1%) died or were admitted to the intensive care unit within 1 day. The area under the receiver operating curve of PAR was 0.87 (95% confidence interval [CI] 0.84–0.89), which was higher than those of modified early warning score (0.66, 95% CI 0.62–0.70), VitalPAC early warning score (0.69, 95% CI 0.66–0.73), standardised early warning score (0.67, 95% CI 0.63–0.70) and cardiac arrest risk triage (0.63, 95% CI 0.59–0.66) (P<0.001).

Conclusions

PAR assessed by RRT nurses can be a useful tool for assessing short-term patient prognosis in the RRT setting.

Klíčová slova:

Cardiac arrest – Heart rate – Intensive care units – Nurses – Oxygen – Physicians – Prognosis


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Článek vyšel v časopise

PLOS One


2019 Číslo 11