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Diurnal Variation in Medical Emergency Team Calls at a Tertiary Care Children’s Hospital

Medical emergency teams (METs) bring critical care expertise to the bedsides of hospital ward patients who may be deteriorating. Diurnal variation in MET activation rates may identify inconsistencies in the detection of patients needing intervention. We aimed to determine whether such variation exis...

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Autores principales: Conway, Susan R., Tegtmeyer, Ken, Wheeler, Derek S., Loechtenfeldt, Allison, Stalets, Erika L., Brady, Patrick W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7480995/
https://www.ncbi.nlm.nih.gov/pubmed/32984741
http://dx.doi.org/10.1097/pq9.0000000000000341
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author Conway, Susan R.
Tegtmeyer, Ken
Wheeler, Derek S.
Loechtenfeldt, Allison
Stalets, Erika L.
Brady, Patrick W.
author_facet Conway, Susan R.
Tegtmeyer, Ken
Wheeler, Derek S.
Loechtenfeldt, Allison
Stalets, Erika L.
Brady, Patrick W.
author_sort Conway, Susan R.
collection PubMed
description Medical emergency teams (METs) bring critical care expertise to the bedsides of hospital ward patients who may be deteriorating. Diurnal variation in MET activation rates may identify inconsistencies in the detection of patients needing intervention. We aimed to determine whether such variation exists at our tertiary care children’s hospital. METHODS: In this retrospective cohort study, we collected data including date and time of MET and disposition following MET for all inpatients at Cincinnati Children’s Hospital Medical Center with a MET call between January 2008 and May 2014. The analysis compared the MET rate between days and nights, weekdays and weekends, and before and after nursing shift change. RESULTS: The number of METs per hour varied throughout the day. More METs were called during the day than at night (0.7 calls/shift ± 0.95 vs 0.6 ± 0.9, P < 0.001). There were also more METs per day on weekdays than weekends (1.4 ± 1 calls/d vs 1.2 ± 1, P < 0.001). Daytime METs were more likely to lead to transfer to the intensive care unit or operating room than those called at night (61.9% vs. 52.9%, P < 0.001). MET activation rates did not differ significantly in the 2 hours before nursing shift change compared to the 2 hours after. CONCLUSIONS: At our large tertiary care children’s hospital, there are both diurnal variations and variations across weekdays versus weekends in the MET activation rate. This difference may indicate variations in our ability to detect deteriorating patients on the wards and be further studied.
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spelling pubmed-74809952020-09-24 Diurnal Variation in Medical Emergency Team Calls at a Tertiary Care Children’s Hospital Conway, Susan R. Tegtmeyer, Ken Wheeler, Derek S. Loechtenfeldt, Allison Stalets, Erika L. Brady, Patrick W. Pediatr Qual Saf Individual QI Projects from Single Institutions Medical emergency teams (METs) bring critical care expertise to the bedsides of hospital ward patients who may be deteriorating. Diurnal variation in MET activation rates may identify inconsistencies in the detection of patients needing intervention. We aimed to determine whether such variation exists at our tertiary care children’s hospital. METHODS: In this retrospective cohort study, we collected data including date and time of MET and disposition following MET for all inpatients at Cincinnati Children’s Hospital Medical Center with a MET call between January 2008 and May 2014. The analysis compared the MET rate between days and nights, weekdays and weekends, and before and after nursing shift change. RESULTS: The number of METs per hour varied throughout the day. More METs were called during the day than at night (0.7 calls/shift ± 0.95 vs 0.6 ± 0.9, P < 0.001). There were also more METs per day on weekdays than weekends (1.4 ± 1 calls/d vs 1.2 ± 1, P < 0.001). Daytime METs were more likely to lead to transfer to the intensive care unit or operating room than those called at night (61.9% vs. 52.9%, P < 0.001). MET activation rates did not differ significantly in the 2 hours before nursing shift change compared to the 2 hours after. CONCLUSIONS: At our large tertiary care children’s hospital, there are both diurnal variations and variations across weekdays versus weekends in the MET activation rate. This difference may indicate variations in our ability to detect deteriorating patients on the wards and be further studied. Lippincott Williams & Wilkins 2020-09-07 /pmc/articles/PMC7480995/ /pubmed/32984741 http://dx.doi.org/10.1097/pq9.0000000000000341 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Individual QI Projects from Single Institutions
Conway, Susan R.
Tegtmeyer, Ken
Wheeler, Derek S.
Loechtenfeldt, Allison
Stalets, Erika L.
Brady, Patrick W.
Diurnal Variation in Medical Emergency Team Calls at a Tertiary Care Children’s Hospital
title Diurnal Variation in Medical Emergency Team Calls at a Tertiary Care Children’s Hospital
title_full Diurnal Variation in Medical Emergency Team Calls at a Tertiary Care Children’s Hospital
title_fullStr Diurnal Variation in Medical Emergency Team Calls at a Tertiary Care Children’s Hospital
title_full_unstemmed Diurnal Variation in Medical Emergency Team Calls at a Tertiary Care Children’s Hospital
title_short Diurnal Variation in Medical Emergency Team Calls at a Tertiary Care Children’s Hospital
title_sort diurnal variation in medical emergency team calls at a tertiary care children’s hospital
topic Individual QI Projects from Single Institutions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7480995/
https://www.ncbi.nlm.nih.gov/pubmed/32984741
http://dx.doi.org/10.1097/pq9.0000000000000341
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