Ott, Lora Kay
(2011)
Medical Emergency Team Calls in Radiology:In-patient Characteristics and Outcomes.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Purpose: The purpose of this pilot study is to describe characteristics of hospitalized patients who experience a Medical Emergency Team activation in the Radiology Department (RD-MET) and their outcomes post RD-MET intervention. In addition, the study will compare the incidence of RD-MET to the incidence of MET activations occurring on general in-patient units of the same facility for the same time period.Theoretical Rationale: Failure-to-Rescue (FTR) or death of hospitalized patients following a complication is one hospital quality measure. Patient, nursing and organizational characteristics contribute to FTR. Patient instability always precedes FTR. Medical Emergency Teams (MET) activation can deploy critical-care providers to the unstable patient's bedside, but nurses' ability to detect instability and call the MET early improves outcomes. Particularly at risk for undetected instability are patients who require transport to the Radiology Department (RD). Little is known about the characteristics of patients who require MET activation while in the RD (RD-MET), factors associated with their nursing surveillance, and outcomes. Once known, modifiable characteristics could undergo intervention to improve outcomes.Methods: A descriptive comparative survey design pilot study will be conducted. We will 1) describe RD-MET patients in regard to their a) non-modifiable patient characteristics, b) modifiable patient characteristics, and c) modifiable surveillance characteristics, 2) determine differences in the characteristic profiles of patients who have poor outcomes post RD-MET (FTR [death before discharge], require higher care level post-MET) and patients with good outcomes (survive to discharge, return to same care level post-MET) and 3) compare the incidence of RD-MET to MET incidence on in-patient units in the same interval. Data will be obtained from the electronic medical record, Medical Emergency Database, and RD documentation. Analyses: The detailed descriptive analyses of the data, using standard descriptive summaries (e.g., means, standard deviation, percentiles, ranges and frequencies) and graphical techniques (e.g., histograms, scatter plots) will be used to describe the non-modifiable patient characteristics, modifiable patient characteristics and modifiable surveillance characteristics.The Student t-test, nonparametric test and/or chi-square test will be used as appropriate to compare the patient characteristics profile between two groups (patients with good outcome and patients with bad outcome). Logistic regression will be performed to identify predictors of patient at risk for poor outcomes post MET activation in the RD. The ratio of occurrence in the RD will be measured by the number of MET activations in the RD during the study period per 1000 RD in-patient admissions (procedures) during the study period. The ratio of occurrence in the general hospital population will be measured as the number of MET activations per 1000 hospital admissions. The chi-square test will be used to compare the difference of incidence rate between RD and general in-patient unit.Implications: Prospective identification of risk for instability and poor RD-MET outcomes will lead to development of targeted surveillance and educational interventions to improve safety and decrease FTR in the RD.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
8 August 2011 |
| Date Type: |
Completion |
| Defense Date: |
14 July 2011 |
| Approval Date: |
8 August 2011 |
| Submission Date: |
3 April 2011 |
| Access Restriction: |
5 year -- Restrict access to University of Pittsburgh for a period of 5 years. |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Nursing > Nursing |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
failure to rescue; medical emergency teams; nursing surveillance; patient instability; patient safety; radiology |
| Other ID: |
http://etd.library.pitt.edu/ETD/available/etd-04032011-212404/, etd-04032011-212404 |
| Date Deposited: |
10 Nov 2011 19:34 |
| Last Modified: |
15 Nov 2016 13:38 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/6727 |
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