快速反应系统对住院患者临床结局影响的系统评价再评价
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摘要
目的 :将快速反应系统(RRS)对住院患者临床结局影响的系统评价进行再评价。方法 :计算机检索The Cochrane Library、PubMed、Medline、CINAHL、EMBASE、CNKI、CMB、WANFANG和VIP数据库,收集RRS的应用对住院患者临床结局影响的系统评价或Meta分析。2位研究者分别独立进行文献筛选、资料提取,采用AMSTAR量表对纳入研究进行方法学质量评价。结果:共纳入14篇系统评价。AMSTAR评价结果显示,仅4篇为高质量,报告最差的条目为"是否提供了纳入和排除的研究文献清单"(12篇),"发表状态是否已考虑在纳入标准中"(11篇)和"是否提供了前期设计方案"(11篇),其次是"是否说明相关的利益冲突"(10篇)。结论 :目前RRS对住院患者临床结局影响的系统评价的方法学质量总体不高。RRS对住院患者临床结局起积极作用,但临床全面推荐开展RRS来优化不良事件管理尚须进一步探讨和验证,同时也提示护理人员须全面提升自身专业水平,以适应RRS的要求。
Objective: To reevaluation the systematic review of the impact of all Rapid Response Systems(RRS) on clinical outcomes in inpatients. Method: The Cochrane Library, PubMed, Medline, CINAHL, EMBASE, CNKI, CMB,WANFANG and VIP database were searched for systematic review or Meta analysis of the impact of all RRS on clinical outcomes in inpatients. Two authors independently screened literature, extracted data and assessed the quality of included studies using the AMSTAR scale. Results: A total of 14 systematic reviews were included. The AMSTAR evaluation results showed that only 4 articles were of high quality, and the worst items in the report were "whether a list of included and excluded research literature was provided"(12 articles), and "whether publishing status was considered in including criteria"(11 articles) " whether a preliminary design scheme was provided"(11 articles), followed by "whether the relevant conflicts of interest were explained"(10 articles). Conclusion: The quality of methodology in systematic review is generally poor. The RRS plays a positive role in the prognosis of in patients, while it still needs further discussion and verification to recommend in clinical to optimize the management of adverse events. It also indicates nurses should improve their professional level to meet the needs of RRS.
Objective: To reevaluation the systematic review of the impact of all Rapid Response Systems(RRS) on clinical outcomes in inpatients. Method: The Cochrane Library, PubMed, Medline, CINAHL, EMBASE, CNKI, CMB,WANFANG and VIP database were searched for systematic review or Meta analysis of the impact of all RRS on clinical outcomes in inpatients. Two authors independently screened literature, extracted data and assessed the quality of included studies using the AMSTAR scale. Results: A total of 14 systematic reviews were included. The AMSTAR evaluation results showed that only 4 articles were of high quality, and the worst items in the report were "whether a list of included and excluded research literature was provided"(12 articles), and "whether publishing status was considered in including criteria"(11 articles) " whether a preliminary design scheme was provided"(11 articles), followed by "whether the relevant conflicts of interest were explained"(10 articles). Conclusion: The quality of methodology in systematic review is generally poor. The RRS plays a positive role in the prognosis of in patients, while it still needs further discussion and verification to recommend in clinical to optimize the management of adverse events. It also indicates nurses should improve their professional level to meet the needs of RRS.
引文
[1]周越,叶磊,田永明,等.中文版临床不良事件上报态度量表的信效度研究.中华护理杂志,2015,50(11):1396-1399.Zhou Y,Ye L,Tian YM,et al.Reliability and validity of Chinese version of attitude scale for reporting clinical adverse events.Chinese Journal of Nursing,2015,50(11):1396-1399.
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[8]Kronick SL,Kurz MC,Lin S,Edelson DP,et al.Part 4:Systems of Care and Continuous Q u a l it y I m p r ove me nt:2015 A me r ic a n Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation,2015,132(18Suppl 2):S397-S413.
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[12]Winters BD,Weaver SJ,Pfoh ER,et al.Rapid-response systems as a patient safety strategy:a systematic review.Ann Intern Med,2013,158(5 Pt 2):417-425.
[13]Lee JR,Kim EM,Kim SA,et al.A systematic review of early warning systems'effects on nurses'clinical performance and adverse events among deteriorating ward patients.J Patient Saf,2018,25(4):1-10.
[14]Daniele R,Bova A,LeGar M,et al.Rapid response team composition effects on outcomes for adult hospitalised patients:a systematic review.JBI Libr Syst Rev,2011,9(31):1297-1340.
[15]Solomon RS,Corwin GS,Barclay DC,et al.Effectiveness of rapid response teams on rates of in-hospital cardiopulmonary arrest and mortality:a systematic review and Meta-analysis.J Hosp Med,2016,11(6):438-445.
[16]Tirkkonen J,Tamminen T,Skrifvars M.Outcome of adult patients attended by rapid response teams:a systematic review of the literature.Resuscitation,2017,112(3):43-52.
[17]Mcneill G,Bryden D.Do either early warning systems or emergency response teams improve hospital patient survival?A systematic review.Resuscitation,2013,84(12):1652-1667.
[18]Rocha H,Alcantara A,Rocha S,et al.Effectiveness of rapid response teams in reducing intrahospital cardiac arrests and deaths:a systematic review and Meta-analysis.Rev Bras Ter Intensiva,2018,30(3):366-375.
[19]Maharaj R,Raffaele I,Wendon J.Rapid response systems:a systematic review and metaanalysis.Crit Care,2015,19(1):254.
[20]De Jong A,Jung B,Daurat A,et al.Effect of rapid response systems on hospital mortality:a systematic review and Meta-analysis.Intensive Care Med,2016,42(4):615-617.
[21]Ranji S,Auerbach A,Hurd C,et al.Effects of rapid response systems on clinical outcomes:Systematic review and Meta-analysis.J Hosp Med,2010,2(6):422-432.
[22]McDowald K,Direktor S,Hynes EA,et al.Effectiveness of collaboration between emergency department and intensive care unit teams on mortality rates of patients presenting with critical illness:a systematic review.JBI Database System Rev Implement Rep,2017,15(9):2365-2389.
[23]Chan PS,Jain R,Nallmothu B K,et al.Rapid Response Teams:a systematic review and Metaanalysis.Archives of Internal Medicine,2010,170(1):18-26.
[24]刘旭,秦历杰.快速反应系统影响院内心脏呼吸骤停和死亡的荟萃分析.河南医学研究,2017(24):4417-4422.Liu X,Qin LJ.The effects of rapid response system on hospital cardiac respiratory arrest and death:systematic review and Meta-analysis.Henan Medical Research,2017(24):4417-4422.
[25]Jensen JK,Sk?r R,Tveit B.The impact of Early Warning Score and Rapid Response Systems on nurses'competence:an integrative literature review and synthesis.Journal of Clinical Nursing,2018,27(4):7-8.
[26]Allen E,Elliott D,Jackson D.Recognising and responding to in-hospital clinical deterioration:an integrative review of interprofessional practice issue.J Clin Nurs,2017,26(12):3990-4012.
[27]Waldie J,Tee S,Day T.Reducing avoidable deaths from failure to rescue:a discussion paper.Br J Nurs,2016(25):895-900.
[2]Taenzer AH,Pyke JB,McGrath SP.A review of current and emerging approaches to address failure-to-rescue.Anesthesiology,2011,115(2):421-431.
[3]Vries E,Ramrattan MA,Smorenburg SM,et al.The incidence and nature of in-hospital adverse events:a systematic review.Quality&Safety in Health Care,2008,17(3):216-223.
[4]Vlayen A,Verelst S,Bekkering G,et al.Incidence and preventability of adverse events requiring intensive care admission:a systematic review.J Eval Clin Pract,2012,18(2):485-497.
[5]Berwick DM,Calkins DR,Mccannon CJ,et al.The 100000 lives campaign:setting a goal and a deadline for improving health care quality.JAMA,2006,295(3):324-327.
[6]Institute for Healthcare Improvement.Overview of the 100,000 lives campaign.(2014-09-18)[2018-12-01].https://www.ihi.org/Engage/Initiatives/Completed/5MillionLivesCampaign/Documents/Overview%20of%20 the%20100K%20Campaign.pdf.
[7]Link MS,Berkow LC,Kudenchuk PJ,et al.Part 7:Adult advanced cardiovascular life support:2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation,2015,132(18 Suppl 2):S444-S464.
[8]Kronick SL,Kurz MC,Lin S,Edelson DP,et al.Part 4:Systems of Care and Continuous Q u a l it y I m p r ove me nt:2015 A me r ic a n Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation,2015,132(18Suppl 2):S397-S413.
[9]Shea BJ,Grimshaw JM,Wells GA,et al.Development of AMSTAR:a measurement tool to assess the methodological quality of systematic review.BMC Med Res Methodol,2007,7(1):10-16.
[10]曾宪涛,冷卫东,李胜,等.如何正确理解及使用GRADE系统.中国循证医学杂志,2011,11(9):985-990.Zeng XT,Leng WD,Li S,et al.How to correctly understand and use GRADE system.Chinese Journal of Evidence-Based Medicine,2011,11(9):985-990.
[11]Winters BD,Pham JC,Hunt EA,et al.Rapid response systems:a systematic review.Critical Care Medicine,2007,35(5):1238-1243.
[12]Winters BD,Weaver SJ,Pfoh ER,et al.Rapid-response systems as a patient safety strategy:a systematic review.Ann Intern Med,2013,158(5 Pt 2):417-425.
[13]Lee JR,Kim EM,Kim SA,et al.A systematic review of early warning systems'effects on nurses'clinical performance and adverse events among deteriorating ward patients.J Patient Saf,2018,25(4):1-10.
[14]Daniele R,Bova A,LeGar M,et al.Rapid response team composition effects on outcomes for adult hospitalised patients:a systematic review.JBI Libr Syst Rev,2011,9(31):1297-1340.
[15]Solomon RS,Corwin GS,Barclay DC,et al.Effectiveness of rapid response teams on rates of in-hospital cardiopulmonary arrest and mortality:a systematic review and Meta-analysis.J Hosp Med,2016,11(6):438-445.
[16]Tirkkonen J,Tamminen T,Skrifvars M.Outcome of adult patients attended by rapid response teams:a systematic review of the literature.Resuscitation,2017,112(3):43-52.
[17]Mcneill G,Bryden D.Do either early warning systems or emergency response teams improve hospital patient survival?A systematic review.Resuscitation,2013,84(12):1652-1667.
[18]Rocha H,Alcantara A,Rocha S,et al.Effectiveness of rapid response teams in reducing intrahospital cardiac arrests and deaths:a systematic review and Meta-analysis.Rev Bras Ter Intensiva,2018,30(3):366-375.
[19]Maharaj R,Raffaele I,Wendon J.Rapid response systems:a systematic review and metaanalysis.Crit Care,2015,19(1):254.
[20]De Jong A,Jung B,Daurat A,et al.Effect of rapid response systems on hospital mortality:a systematic review and Meta-analysis.Intensive Care Med,2016,42(4):615-617.
[21]Ranji S,Auerbach A,Hurd C,et al.Effects of rapid response systems on clinical outcomes:Systematic review and Meta-analysis.J Hosp Med,2010,2(6):422-432.
[22]McDowald K,Direktor S,Hynes EA,et al.Effectiveness of collaboration between emergency department and intensive care unit teams on mortality rates of patients presenting with critical illness:a systematic review.JBI Database System Rev Implement Rep,2017,15(9):2365-2389.
[23]Chan PS,Jain R,Nallmothu B K,et al.Rapid Response Teams:a systematic review and Metaanalysis.Archives of Internal Medicine,2010,170(1):18-26.
[24]刘旭,秦历杰.快速反应系统影响院内心脏呼吸骤停和死亡的荟萃分析.河南医学研究,2017(24):4417-4422.Liu X,Qin LJ.The effects of rapid response system on hospital cardiac respiratory arrest and death:systematic review and Meta-analysis.Henan Medical Research,2017(24):4417-4422.
[25]Jensen JK,Sk?r R,Tveit B.The impact of Early Warning Score and Rapid Response Systems on nurses'competence:an integrative literature review and synthesis.Journal of Clinical Nursing,2018,27(4):7-8.
[26]Allen E,Elliott D,Jackson D.Recognising and responding to in-hospital clinical deterioration:an integrative review of interprofessional practice issue.J Clin Nurs,2017,26(12):3990-4012.
[27]Waldie J,Tee S,Day T.Reducing avoidable deaths from failure to rescue:a discussion paper.Br J Nurs,2016(25):895-900.
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