NURS9222 Assignment 1: Rapid Response Team and Clinical Deterioration

This report presents a critical review protocol evaluating the effectiveness of Rapid Response Teams (RRTs) in identifying clinical deterioration among hospitalized patients, focusing on adherence to National Safety and Quality Health Service (NSQHS) standards. The study explores the rationale for the topic, emphasizing the increasing incidence of clinical deterioration and its adverse effects, such as cardiac arrest and prolonged hospital stays. The research employs the PICO framework to formulate a clear research question: "Evaluation of the Rapid response team on identifying clinical deterioration among hospitalized patients as per National safety and quality health standards." Inclusion and exclusion criteria are defined to guide the selection of relevant studies, with a focus on studies addressing clinical deterioration and RRTs, while excluding older studies and those not in English. The research methodology involves a qualitative approach, utilizing questionnaires to assess the RRT's effectiveness. The search strategy encompasses various databases, including Google Scholar, PubMed, CINAHL, Cochrane, and MEDLINE, with specific keywords related to clinical deterioration and RRTs. The report also outlines a plan for effective appraisal of the quality and relevance of the articles. The conclusion summarizes the importance of RRTs in improving patient health outcomes through early identification of clinical deterioration and providing proper interventions.

Critical Review
Protocol

Table of Contents
INTRODUCTION...........................................................................................................................1
RATIONALE OF CHOSEN TOPIC...............................................................................................1
RESEARCH QUESTIONS.............................................................................................................1
INCLUSION/EXCLUSION CRITERIA USING PICO FRAMEWORK......................................2
Specification of the study types..............................................................................................3
Search strategy methods.........................................................................................................3
Indicative plan for effective appraisal....................................................................................4
Conclusion.......................................................................................................................................4
REFERENCES................................................................................................................................5

INTRODUCTION
Clinical deterioration is a physiological decompensation that occurs within patients when
they experience worsening condition or are experiencing serious psychological disturbance
(Lambert and et. al., 2017). It is important to focus upon clinical deterioration because it can
impact a patient and result in longer hospital stay, cardiac arrest, increasing morality rate. Rapid
response team is one of the most important pillar (care providers) of healthcare organization that
can help in early identification of clinical deterioration in order to escalate care in response to a
patient’s deteriorating health so that patients can be discharged as soon as possible and chances
of morality can also be reduced. For this NSQHS (National safety and quality health standards)
standards can be applied within hospitals so that complexity of admission process can be
reduced, focus towards safe patient care can be increased, treatment of patients suffering from
clinical deterioration can be done. So the main aim of this research is to evaluate Rapid response
team for identification of clinical deterioration among hospitalized patients as per National safety
and quality health standards.
RATIONALE OF CHOSEN TOPIC
Clinical deterioration nowadays among patients is increasing due to worsening conditions
like complex admission process, degraded patient care. If clinical deterioration is not identified
at early stages then it can have some adverse effects upon patients for example: they can suffer
from cardiac arrest, mortality chances can increase or they have to stay within hospital a little
longer (Greiner and et. al., 2020). Due to this it has become important to identify clinical
deterioration among hospitalised patients. For this a Rapid response Team can be formed that
can help in development of a system though which this clinical deterioration can be identified as
soon as possible. For this NSQHS standard 9 can be applied though which a safe and quality care
can be provided to patients or EWS protocol (Early warning system protocol) can be developed
for early detection of clinical deterioration.
RESEARCH QUESTIONS
Component Description Research Questions
P- Participants or population Identification of patient/
process/ population which is
Hospitalized patients who are
suffering from clinical
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being investigated is done deterioration
I- Intervention Intervention or practise which
is being practised is compared
Identify clinical deterioration
through Rapid response team
by applying EWS protocols
C- Comparison Group or unit which is being
compared is identified
Is NSQHS -ZERO EVENT an
alternative standards that can
be used by Rapid response
team for identification of
clinical deterioration
O- Outcome Identifies end result which is
required to be achieved
Reduce early hospital stay by
early identification of
clinical deterioration which
will further help in reducing
morality rate.
In order to identify main research question PICO technique has been used. This technique
has been used because it helps in identifying main population which is being focused upon in the
study, it further helps in identifying two main interventions that are being focused upon and
being compared so that desired outcome can be identified. This technique has helped in
identifying Research question which is required to be focused upon. Research question
identified with this technique is: Evaluation of the Rapid response team on identifying clinical
deterioration among hospitalized patients as per National safety and quality health standards
INCLUSION/EXCLUSION CRITERIA USING PICO FRAMEWORK
Inclusion criteria:
 Study that included identification of clinical deterioration among hospitalized patients
 Study in which evaluation of the Rapid response team for identification of clinical
deterioration
 Study that focused upon implementation of NSQHS standards for increased patient safety
and care.
Exclusion criteria:
 Studies that were more that 5 years old were not included within the study
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 Studies that did not address research question
 Studies that were written in language other than English
Specification of the study types
Selecting study type is one of the main steps which allows researcher in performing further steps
like taking decision regarding research type, approaches and others. On the basis of the type of
research as whether it is qualitative and quantitative, researcher select the type of data collection
or sources of it (Vindrola-Padros and Johnson, 2020). For example for qualitative research and
for gathering non numerical data researcher often focuses on literatures or books and journals.
This study is qualitative and for this questionnaire will be used in order to know effectiveness
and roles played by rapid response team in order to identify early signs of clinical deterioration
in hospitalized patients. It is important to identify early signs and playing effective roles as it
helps them out in reducing hospital stay as well as mortality rate. By conducting systematic
review of both qualitative and quantitative research or collected data, researcher can accomplish
their goals in an effective manner.
Search strategy methods
It is important to start search process with a broad search for gathering information easily
relevant to the topic (Wang, Chin and Lin, 2020). One of the main aims of this study is
establishing literacy scope for the topic and identifying effective keywords used in the study
which can give overall outcome and conclusion of the study. There are some search engines
which have been used in this study along with key words such as:
Search engine include: Google scholar and Google web browser, PubMed, CINAHL, Cochrane
and MEDLINE.
Medline is considered the primary component of PubMed and it plays an important role as it
includes literature published from 1996 to present. For this present study, Medline is one of the
reliable sources as it allows people to see that who conducted research, who wrote results and
where research was conducted.
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Keywords include: Research, Study, paediatric early warning systems, detection, deterioration,
emergency etc.
From this effectiveness of search terms can be identified and it can be done with received
outcomes.
Indicative plan for effective appraisal
Maintaining quality and relevancy is important for researcher as it improves their image and
also makes them able to make study successful and also setting effective outcomes (Allen,
Cohen and Hammond, 2020). By making use of an effective appraisal system, consistent and
valid data can be gathered as it helps us out in knowing all major roles of rapid response team
towards hospitalized patients in knowing signs of clinical deterioration and preventing them
against future complications and cardiac arrest. There are some other side has been known which
requires effectiveness such as: there is reduction of rapid response team ration at night which is
affecting performance and health of hospitalized patients and quality of care indicators.
Conclusion
It has been summarized on the basis of the study that examining hospitalized paediatric early
warning systems is not an easy healthcare intervention. By making an effective use of leadership,
rapid response of team to hospitalized patients played a vital role as it makes them able to
improve their health by providing proper guidance and interventions as per their nature and the
extent of disease. It has also shown roles played by medical emergency team in responding to
hospitalized patients by knowing early signs of deterioration on non-intensive care for preventing
them against chronic and cardiac arrest. Search methojdojlojg6y also played a vital role as it
provides an effective framework form for addressing the main issue along with strategies for
solution.
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REFERENCES
Books & Journals
Allen, S.R., Cohen, B. and Hammond, G.P., 2020. Indicative appraisal of clustered micro-
generators for a low-carbon transition in the UK building sector. Global Transitions, 2,
pp.83-97.
Boscart, V.M. and et.al., 2018. The associations between staffing hours and quality of care
indicators in long-term care. BMC health services research, 18(1), p.750.
Greiner, A.L., and et. al., 2020. Challenges in public health rapid response team
management. Health security, 18(S1), pp.S-8.
Lambert, V., and et. al., 2017. Paediatric early warning systems for detecting and responding to
clinical deterioration in children: a systematic review. BMJ open, 7(3).
Mays, N. and Pope, C., 2020. Quality in qualitative research. Qualitative research in health care,
pp.211-233.
Vindrola-Padros, C. and Johnson, G.A., 2020. Rapid techniques in qualitative research: A critical
review of the literature. Qualitative Health Research, 30(10), pp.1596-1604.
Wang, C., Chin, T. and Lin, J.H., 2020. Openness and firm innovation performance: the
moderating effect of ambidextrous knowledge search strategy. Journal of Knowledge
Management.
ONLINE
Impact of nighttimes Rapid Response Team activation on outcomes of hospitalized patients with
acute deterioration 2018. Online Available through: <
https://ccforum.biomedcentral.com/articles/10.1186/s13054-018-2005-1 >
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