The effect of medical emergency teams on patient outcome: A review of the literature.

Int J Nurs Pract. 2010 Dec;16(6):533-44

Authors: Laurens NH, Dwyer TA

Laurens NH, Dwyer TA. International Journal of Nursing Practice 2010; 16: 533-544?The effect of medical emergency teams on patient outcome: A review of the literature This paper presents a review of literature on the impact of the medical emergency team (MET) on inpatient mortality, cardiopulmonary arrests or unscheduled intensive care unit (ICU) admissions. A total of 14?172 abstracts and 98 full text papers were reviewed. In total, 24 met the inclusion criteria, 2 used a cluster-randomized controlled trial, 11 before and after, 6 retrospective analyses, 4 prospective cohorts and 1 not reported. There is moderate to strong evidence that METs are associated with decreased mortality and cardiac arrest rates, and weak evidence on its impact on ICU admission rate reductions. This evidence suffers from the flaws with only two randomized controlled trials examining differing outcome measures with differing results. Poor methodology and failure to report both quality improvement co-interventions and time response rates of METs, limit the strength of the evidence that METs are effective interventions for preventing mortality, code rates or unscheduled ICU admissions. Studies with improved implementation practices and evaluation of the efficacy of MET is warranted.

PMID: 21129105 [PubMed - in process]

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Prevalence of frailty on clinical wards: description and implications.

Int J Nurs Pract. 2010 Feb;16(1):14-9

Authors: Andela RM, Dijkstra A, Slaets JP, Sanderman R

This paper describes the prevalence and frailty level of patients aged > or = 75 years upon admission to various clinical wards. The data collection took place on five clinical wards of different clinical specialisms: Geriatric Centre, traumatology, pulmonology/rheumatology, internal medicine and surgical medicine. The Groningen Frailty Indicator was used to assess the frailty of newly admitted patients. The presence of number and kind of the various frailty indicators was different for the clinical wards, because of clinical diagnose, age and gender. On the Geriatric Centre, almost all patients were indicated as frail. On the other wards, 50-80% of the patients were indicated as frail with most frailty indicators on the scale 'psychosocial'. The study show a high prevalence of frail elderly on some wards and gives an indication of the various needs for other disciplines within the framework of the care for frail elderly people.

PMID: 20158543 [PubMed - indexed for MEDLINE]

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An evaluation of the level of satisfaction with a dedicated inpatient venepuncture service at a rehabilitation centre.

Int J Nurs Pract. 2009 Dec;15(6):553-9

Authors: Oatey A, Stiller K

The purpose of this prospective observational study was to determine the levels of satisfaction of the three main ‘customers’ of a dedicated inpatient venepuncture service at a rehabilitation centre, namely the patients, medical staff and nursing staff. The venepuncture service was delivered by two part-time nurses. One hundred and six patients, 14 medical staff and 35 nurses participated in the study. Three purpose-designed surveys were administered to investigate levels of satisfaction. High degrees of satisfaction were reported by all three ‘customer’ groups. Patients were highly satisfied with the interpersonal skills of the venepuncture nurses and their ability to obtain blood on the first pass, medical staff agreed that a dedicated venepuncture service gave them more time to spend in patient care, and nursing staff believed that a dedicated venepuncture service caused less disruption to patients’ daily schedule.

PMID: 19958410 [PubMed - indexed for MEDLINE]

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