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Improving early recognition of patient deterioration in medical surgical units in a university hospital

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TitleInfo
Title
Improving early recognition of patient deterioration in medical surgical units in a university hospital
Name (type = personal)
NamePart (type = family)
Guimaraes
NamePart (type = given)
Daniela
NamePart (type = date)
1982-
DisplayForm
Daniela Guimaraes
Role
RoleTerm (authority = RULIB)
author
Name (type = personal)
NamePart (type = family)
Miley
NamePart (type = given)
Helen
DisplayForm
Helen Miley
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
chair
Name (type = personal)
NamePart (type = family)
Benenson
NamePart (type = given)
Irina
DisplayForm
Irina Benenson
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
co-chair
Name (type = corporate)
NamePart
Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
Name (type = corporate)
NamePart
School of Nursing - RBHS
Role
RoleTerm (authority = RULIB)
school
TypeOfResource
Text
Genre (authority = marcgt)
theses
OriginInfo
DateCreated (encoding = w3cdtf); (qualifier = exact)
2019
DateOther (encoding = w3cdtf); (qualifier = exact); (type = degree)
2019-05
Language
LanguageTerm (authority = ISO 639-3:2007); (type = text)
English
Abstract (type = abstract)
Worldwide, hospitalized patients that deteriorate acutely may progress rapidly to cardiac arrest, and Modified Early Warning Score (MEWS) algorithms have been developed and implemented in healthcare institutions to early identify and early manage patient deterioration.
Purpose: To determine whether the introduction of a revised MEWS algorithm and an early recognition of patient deterioration education program would influence the number of rapid response calls, escalation of care situations, and number of code blue calls.
Methodology: Performance improvement project with pre-post analysis. Population: Retrospective chart review of adult patients ≥ 18 years of age hospitalized in two medical surgical units in a university hospital, who triggered a Rapid Response Team (RRT) call. Sample number: 111 charts were reviewed prior to the intervention, and 116 charts were reviewed after the intervention. Data collection: After implementation of the revised MEWS algorithm and education program, a retrospective chart review was performed pre-intervention and post-intervention to compare outcome measures (number of rapid response calls, number of code blue calls, and escalation of care situations), patient demographic data, whether the event occurred during the day or night shifts, and whether there was a RRT activation via the MEWS algorithm. Results: Findings showed no statistically significant difference in number of rapid response calls and code blue calls, between pre and post intervention periods, for first and second units. It showed a statistically significant difference in escalation of care situations in the first unit, but no statistically significant difference in escalation of care situations in the second unit between pre and post implementation periods.
Implications for Practice: Hospitalized patients that progress to cardiac arrest have low survival rates, and most of times are discharged from healthcare institutions with neurological or other physical disabilities. Although some findings were not statistically significant, the implementation of a revised MEWS algorithm and an education program generally improved escalation of care situations. There were improvements in early recognition of patient deterioration and patient outcomes, by preventing cardiac arrests from happening. This project assisted in early identifying clinical deterioration and managing hospitalized patients, resulting in a positive impact on patient safety and overall healthcare quality.
Subject (authority = RUETD)
Topic
Adult-Gerontology Acute Care Nurse Practitioner
Subject (authority = local)
Topic
Early recognition
Subject (authority = LCSH)
Topic
Patient monitoring
RelatedItem (type = host)
TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
Identifier (type = RULIB)
ETD
Identifier
ETD_9539
PhysicalDescription
Form (authority = gmd)
InternetMediaType
application/pdf
InternetMediaType
text/xml
Extent
1 online resource (108 pages) : illustrations
Note (type = degree)
DNP
Note (type = bibliography)
Includes bibliographical references
RelatedItem (type = host)
TitleInfo
Title
School of Nursing (RBHS) DNP Projects
Identifier (type = local)
rucore10004500001
Location
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NjNbRU
Identifier (type = doi)
doi:10.7282/t3-ydtq-a642
Genre (authority = ExL-Esploro)
ETD doctoral
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Rights

RightsDeclaration (ID = rulibRdec0006)
The author owns the copyright to this work.
RightsHolder (type = personal)
Name
FamilyName
Guimaraes
GivenName
Daniela
Role
Copyright Holder
RightsEvent
Type
Permission or license
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2019-01-18 12:05:21
AssociatedEntity
Name
Daniela Guimaraes
Role
Copyright holder
Affiliation
Rutgers University. School of Nursing - RBHS
AssociatedObject
Type
License
Name
Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
RightsEvent
Type
Embargo
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2019-05-31
DateTime (encoding = w3cdtf); (qualifier = exact); (point = end)
2099-12-31
Detail
Access to this PDF has been restricted at the author's request.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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2019-01-18T16:22:28
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2019-01-18T11:37:29
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