Managing patient deterioration: evaluation of what works.

Research output: Contribution to conferencePaper

Abstract

Background: Rapid Response Systems (RRS) have been implemented nationally and internationally to improve patient safety in hospital. However, to date the majority of the RRS research evidence has focused on measuring the effectiveness of the intervention on patient outcomes. To evaluate RRS it has been recommended that a multimodal approach is required to address the broad range of process and outcome measures required to determine the effectiveness of the RRS concept. Aim: The aim of this paper is to evaluate the official RRS programme theoretical assumptions regarding how the programme is meant to work against actual practice in order to determine what works. Methods: The research design was a multiple case study approach of four wards in two hospitals in Northern Ireland. It followed the principles of realist evaluation research which allowed empirical data to be gathered to test and refine RRS programme theory [1]. This approach used a variety of mixed methods to test the programme theories including individual and focus group interviews with a purposive sample of 75 nurses and doctors, observation of ward practices and documentary analysis. The findings from the case studies were analysed and compared within and across cases to identify what works for whom and in what circumstances. Results: The RRS programme theories were critically evaluated and compared with study findings to develop a mid-range theory to explain what works, for whom in what circumstances. The findings of what works suggests that clinical experience, established working relationships, flexible implementation of protocols, ongoing experiential learning, empowerment and pre-emptive management are key to the success of RRS implementation.  Conclusion:These findings highlight the combination of factors that can improve the implementation of RRS and in light of this evidence several recommendations are made to provide policymakers with guidance and direction for their success and sustainability.References: 1.Pawson R and Tilley N. (1997) Realistic Evaluation. Sage Publications; LondonType of submission: Concurrent session Source of funding: Sandra Ryan Fellowship funded by the School of Nursing & Midwifery, Queen’s University of Belfast
LanguageEnglish
Publication statusPublished - 03 Apr 2014
EventRCN International Nursing Research conference 2014 - University of Glasgow. , Glasgow, United Kingdom
Duration: 02 Apr 201204 Apr 2012

Conference

ConferenceRCN International Nursing Research conference 2014
CountryUnited Kingdom
CityGlasgow
Period02/04/201204/04/2012

Fingerprint

School Nursing
Northern Ireland
Problem-Based Learning
Process Assessment (Health Care)
Midwifery
Patient Safety
Focus Groups
Research Design
Nurses
Observation
Outcome Assessment (Health Care)
Interviews
Research
Direction compound
Practice (Psychology)
Power (Psychology)

Keywords

  • critical care
  • Realist evaluation
  • patient deterioration

Cite this

McGaughey, J., O'Halloran, P., Porter, S., & Blackwood, B. (2014). Managing patient deterioration: evaluation of what works.. Paper presented at RCN International Nursing Research conference 2014 , Glasgow, United Kingdom.
McGaughey, Jennifer ; O'Halloran, Peter ; Porter, Samuel ; Blackwood, Bronagh. / Managing patient deterioration: evaluation of what works. Paper presented at RCN International Nursing Research conference 2014 , Glasgow, United Kingdom.
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McGaughey, J, O'Halloran, P, Porter, S & Blackwood, B 2014, 'Managing patient deterioration: evaluation of what works.' Paper presented at RCN International Nursing Research conference 2014 , Glasgow, United Kingdom, 02/04/2012 - 04/04/2012, .

Managing patient deterioration: evaluation of what works. / McGaughey, Jennifer; O'Halloran, Peter; Porter, Samuel; Blackwood, Bronagh.

2014. Paper presented at RCN International Nursing Research conference 2014 , Glasgow, United Kingdom.

Research output: Contribution to conferencePaper

TY - CONF

T1 - Managing patient deterioration: evaluation of what works.

AU - McGaughey, Jennifer

AU - O'Halloran, Peter

AU - Porter, Samuel

AU - Blackwood, Bronagh

PY - 2014/4/3

Y1 - 2014/4/3

N2 - Background: Rapid Response Systems (RRS) have been implemented nationally and internationally to improve patient safety in hospital. However, to date the majority of the RRS research evidence has focused on measuring the effectiveness of the intervention on patient outcomes. To evaluate RRS it has been recommended that a multimodal approach is required to address the broad range of process and outcome measures required to determine the effectiveness of the RRS concept. Aim: The aim of this paper is to evaluate the official RRS programme theoretical assumptions regarding how the programme is meant to work against actual practice in order to determine what works. Methods: The research design was a multiple case study approach of four wards in two hospitals in Northern Ireland. It followed the principles of realist evaluation research which allowed empirical data to be gathered to test and refine RRS programme theory [1]. This approach used a variety of mixed methods to test the programme theories including individual and focus group interviews with a purposive sample of 75 nurses and doctors, observation of ward practices and documentary analysis. The findings from the case studies were analysed and compared within and across cases to identify what works for whom and in what circumstances. Results: The RRS programme theories were critically evaluated and compared with study findings to develop a mid-range theory to explain what works, for whom in what circumstances. The findings of what works suggests that clinical experience, established working relationships, flexible implementation of protocols, ongoing experiential learning, empowerment and pre-emptive management are key to the success of RRS implementation.  Conclusion:These findings highlight the combination of factors that can improve the implementation of RRS and in light of this evidence several recommendations are made to provide policymakers with guidance and direction for their success and sustainability.References: 1.Pawson R and Tilley N. (1997) Realistic Evaluation. Sage Publications; LondonType of submission: Concurrent session Source of funding: Sandra Ryan Fellowship funded by the School of Nursing & Midwifery, Queen’s University of Belfast

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KW - critical care

KW - Realist evaluation

KW - patient deterioration

M3 - Paper

ER -

McGaughey J, O'Halloran P, Porter S, Blackwood B. Managing patient deterioration: evaluation of what works.. 2014. Paper presented at RCN International Nursing Research conference 2014 , Glasgow, United Kingdom.