Impact of Pulse Oximetry Surveillance on Rescue Events and Intensive Care Unit Transfers A Before-and-After Concurrence Study

被引:210
作者
Taenzer, Andreas H. [1 ]
Pyke, Joshua B. [1 ]
McGrath, Susan P. [1 ]
Blike, George T. [1 ]
机构
[1] Dartmouth Med Sch, Dartmouth Hitchcock Med Ctr, Dept Anesthesiol, Lebanon, NH 03756 USA
关键词
CARDIAC-ARREST; ANTECEDENTS;
D O I
10.1097/ALN.0b013e3181ca7a9b
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: Some preventable deaths in hospitalized patients are due to unrecognized deterioration. There are no publications of studies that have instituted routine patient monitoring postoperatively and analyzed impact on patient outcomes. Methods: The authors implemented a patient surveillance system based on pulse oximetry with nursing notification of violation of alarm limits via wireless pager, Data were collected for 11 months before and 10 months after implementation of the system. Concurrently, matching outcome data were collected on two other postoperative units. The primary outcomes were rescue events and transfers to the intensive care unit compared before and after monitoring change. Results: Rescue events decreased from 3.4 (1.89-4.85) to 1.2 (0.53-1.88) per 1,000 patient discharges and intensive care unit transfers from 5.6 (3.7-7.4) to 2.9 (1.4-4.3) per 1,000 patient days, whereas the comparison units had no change. Conclusions: Patient surveillance monitoring results in a reduced need for rescues and intensive care unit transfers.
引用
收藏
页码:282 / 287
页数:6
相关论文
共 14 条
[1]   INCIDENCE AND CHARACTERISTICS OF PREVENTABLE LATROGENIC CARDIAC ARRESTS [J].
BEDELL, SE ;
DEITZ, DC ;
LEEMAN, D ;
DELBANCO, TL .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1991, 265 (21) :2815-2820
[2]   INCIDENCE OF ADVERSE EVENTS AND NEGLIGENCE IN HOSPITALIZED-PATIENTS - RESULTS OF THE HARVARD MEDICAL-PRACTICE STUDY-I [J].
BRENNAN, TA ;
LEAPE, LL ;
LAIRD, NM ;
HEBERT, L ;
LOCALIO, AR ;
LAWTHERS, AG ;
NEWHOUSE, JP ;
WEILER, PC ;
HIATT, HH .
NEW ENGLAND JOURNAL OF MEDICINE, 1991, 324 (06) :370-376
[3]   Recognising clinical instability in hospital patients before cardiac arrest or unplanned admission to intensive care - A pilot study in a tertiary-care hospital [J].
Buist, MD ;
Jarmolowski, E ;
Burton, PR ;
Bernard, SA ;
Waxman, BP ;
Anderson, J .
MEDICAL JOURNAL OF AUSTRALIA, 1999, 171 (01) :22-25
[4]   A prospective study of factors influencing the outcome of patients after a Medical Emergency Team review [J].
Calzavacca, Paolo ;
Licari, Elisa ;
Tee, Augustine ;
Egi, Moritoki ;
Haase, Michael ;
Haase-Fielitz, Anja ;
Bellomo, Rinaldo .
INTENSIVE CARE MEDICINE, 2008, 34 (11) :2112-2116
[5]  
CHRISTOFFERSEN K, 2001, P HUM FACT ERG SOC 4, P409
[6]  
DELORENZO R, 1999, TACTICAL EMERGENCY C, P201
[7]   DEVELOPING STRATEGIES TO PREVENT INHOSPITAL CARDIAC-ARREST - ANALYZING RESPONSES OF PHYSICIANS AND NURSES IN THE HOURS BEFORE THE EVENT [J].
FRANKLIN, C ;
MATHEW, J .
CRITICAL CARE MEDICINE, 1994, 22 (02) :244-247
[8]  
Hillman K, 2005, LANCET, V365, P2091
[9]   Antecedents to hospital deaths [J].
Hillman, KM ;
Bristow, PJ ;
Chey, T ;
Daffurn, K ;
Jacques, T ;
Norman, SL ;
Bishop, GF ;
Simmons, G .
INTERNAL MEDICINE JOURNAL, 2001, 31 (06) :343-348
[10]   Precise formulation and evidence-based application of resource-constrained triage [J].
Sacco, WJ ;
Navin, M ;
Fiedler, KE ;
Waddell, RK ;
Long, WB ;
Buckman, RF .
ACADEMIC EMERGENCY MEDICINE, 2005, 12 (08) :759-770