Dados do Resumo

Título

Impact of the active search for nurses from the rapid response team on the outcome of cancer patients with clinical deterioration in inpatient units

Introdução

The Rapid Response Team (TRR) is a team composed of a doctor, nurse and physiotherapist with expertise in critical care, who must be quickly activated to provide care to patients experiencing clinical deterioration and/or cardiorespiratory arrest, located in any unit/area considered to be unsafe. criticism.  In addition to calls via activation, TRR nurses carry out an active search for patients in clinical deterioration in hospitalization units on a daily basis, identifying them early and preventing developments in serious adverse events.

Objetivo

Early identify potential patients for clinical deterioration hospitalized in non-critical areas, provide recognition and early treatment in order to prevent serious events and evaluate the impacts of this active search through the outcomes of care provided by the TRR.

Métodos

Retrospective analysis of the clinical outcomes of patients cared for by TRR nurses in the inpatient unit through active search carried out between the months of April and July 2024. To assess the patient's health status and identify the need for care by the TRR team, the MEWS (Modified Early Warning Score) and PEWS (Pediatric Early Warning Score) scores were used, which assess the vital signs and level of responsiveness of adult and pediatric patients, respectively, and early identify patients at risk of physiological deterioration. The active search is carried out through periodic rounds at nursing stations looking for patients with changes in vital signs and, given the change, the nurse evaluates the patient and indicates the Team's evaluation, which may result in early intervention for the patient, such as going to the hospital. ICU, for example.

Resultados

Between April and July 2024, TRR nurses treated 108 patients with significant clinical changes through active search. Of these, 62% improved after bedside care, 27% were transferred to the ICU, with 37% of patients being transferred immediately after assessment and 63% being transferred after reassessment and bedside interventions. 11% had directives to limit support after evaluation by the team's nurses. As an outcome, we observed that 27 were discharged from the ICU to the hospitalization unit and subsequently discharged from the hospital and 3 patients died during their stay in the intensive care unit.
90% of patients transferred to the ICU after an active search by the RRT nurse were discharged from hospital, while patients evaluated by nurses after activation of the hospitalization unit, 64% of patients were discharged from hospital. These data prove that the active search for patients with clinical deterioration in the units contributes to reducing mortality and improving patient outcomes during their hospitalization.

Conclusões

The active search for patients with changes in vital signs by RRT nurses proved to be a beneficial practice that allows rapid intervention in cases of clinical deterioration, positively impacting the hospitalized patient's journey, resulting in the prevention of serious adverse events related to organic dysfunctions, rapid intervention in cases of clinical deterioration, fewer transfers to the ICU and better clinical outcomes.

Palavras Chave

critical care; clinical deterioration; Oncology Nursing