Use of the pre-medical emergency team tier of rapid response systems: A scoping Review

Stephanie K Sprogis; Judy Currey; Daryl Jones; Julie Considine

doi:10.1016/j.iccn.2021.103041

Use of the pre-medical emergency team tier of rapid response systems: A scoping Review

Intensive Crit Care Nurs. 2021 Aug:65:103041. doi: 10.1016/j.iccn.2021.103041. Epub 2021 Mar 30.

Authors

Stephanie K Sprogis¹, Judy Currey², Daryl Jones³, Julie Considine⁴

Affiliations

¹ Deakin University: School of Nursing and Midwifery & Centre for Quality and Patient Safety in the Institute for Health Transformation, 1 Gheringhap St, Geelong, Victoria 3220, Australia. Electronic address: https://twitter.com/@Steph_Sprogis.
² Deakin University: School of Nursing and Midwifery & Centre for Quality and Patient Safety in the Institute for Health Transformation, 1 Gheringhap St, Geelong, Victoria 3220, Australia; Deakin University: Deakin Learning Futures, Office of the Deputy Vice Chancellor (Education), 1 Gheringhap St, Geelong, Victoria 3220, Australia. Electronic address: https://twitter.com/@Judy_Currey.
³ Department of Intensive Care, Austin Hospital, 145 Studley Rd, Heidelberg, Victoria, 3084, Australia; School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, Victoria 3800, Australia; Department of Surgery, University of Melbourne, Parkville, Victoria 3010, Australia. Electronic address: https://twitter.com/@jones_daza.
⁴ Deakin University: School of Nursing and Midwifery & Centre for Quality and Patient Safety in the Institute for Health Transformation, 1 Gheringhap St, Geelong, Victoria 3220, Australia; Centre for Quality and Patient Safety Research - Eastern Health Partnership, 2/5 Arnold St, Box Hill, Victoria 3128, Australia. Electronic address: https://twitter.com/@Julie_Considine.

PMID: 33795182
DOI: 10.1016/j.iccn.2021.103041

Abstract

Objective: The aim of this review was to explore use of the pre-Medical Emergency Team (pre-MET) tier of Rapid Response Systems to recognise and respond to adult ward patients experiencing early clinical deterioration.

Methods: A scoping review of studies published in English reporting on use of a pre-MET tier in adult ward patients was conducted. Three databases were searched (Medline, CINAHL, EMBASE) for studies published between January 1995 and September 2020. Two researchers independently performed screening and quality assessments. Findings were synthesised thematically. Reporting of the review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews.

Results: Six of 1669 studies were included in this review. All were single-site studies of single-parameter Rapid Response Systems in Australian hospitals. Five were quantitative studies; one had a qualitative design. Studies fulfilled 50-100% of quality criteria. Two themes were constructed: Afferent processes - Recognising and escalating pre-MET events; and Efferent processes - Pre-MET reviews and associated interventions. There was disparity between clinical practice and pre-MET escalation protocols, and reports of nurse-initiated management of early deterioration. Prospective methods and exploration of multidisciplinary perspectives were notable research gaps.

Conclusion: Use of the pre-MET tier of Rapid Response Systems is under-researched. Further research is needed to understand barriers and facilitators influencing use of pre-MET strategies to address patient deterioration.

Keywords: Clinical deterioration; Early medical intervention; Hospital rapid response team; Nursing; Patient care team; Patient safety.

Publication types

Review
Systematic Review

MeSH terms

Adult
Australia
Clinical Deterioration*
Emergency Service, Hospital
Humans