Identification of barriers to awareness and rapid response to patient deterioration and development of response strategies

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K10775
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 58060:Clinical nursing-related
• Research Institution: Shiga University of Medical Science (2021-2022); Graduate School of Health Care Science, Jikei Institute (2020)
• Principal Investigator: Kasahara Satoko 滋賀医科大学, 医学部, 教授 (30283782)
• Co-Investigator(Kenkyū-buntansha): 石松 一真 滋慶医療科学大学, 医療管理学研究科, 教授 (30399505) ; 大野 ゆう子 大阪大学, 大学院基礎工学研究科, 特任教授(常勤) (60183026)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 患者急変 / 院内迅速対応システム / 気づき / 看護ケア

Outline of Final Research Achievements

Recognizing promptly the deterioration of ward patients and promptly transferring them onto specialized systems is crucial to prevent unexpected death.The implementation of proactive rounds conducted by the Rapid Response Team (RRT) within the ward has resulted in an escalation of RRT calls from the nursing staff in response to patient deterioration.However, the time taken to activate the RRS after meeting the RRT calling criteria still remains lengthy, indicating the limitations of our conventional approaches.
We examined the nurses’ behavior process, extracted from medical records, regarding the sequence of events from the recognition of patient deterioration to the RRT calls, with the inclusion of a cognitive process perspective, in order to elucidate the "barriers" to RRT activation.

Free Research Field

基礎看護学、看護管理学

Academic Significance and Societal Importance of the Research Achievements

本研究は、RRSの迅速な起動を妨げる「障壁」について、実際の行動プロセスだけでなく、組織との相互作用により影響をうける認知プロセス、組織管理データによる知見を加え複合的に検討する。このような多面的検討は、医療安全の問題解決手法であるレジリエンス・エンジニアリングの理念に合致する。本研究により、「障壁」克服に向けたシステム改善のための現実的で優れた備えを提案し、RRSの迅速な起動を目指すことで、患者アウトカムの改善への寄与が期待できる。