Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/26041
Title: Modifications to medical emergency team activation criteria and implications for patient safety: A point prevalence study.
Austin Authors: Sprogis, Stephanie K;Street, Maryann;Currey, Judy;Jones, Daryl A ;Newnham, Evan;Considine, Julie
Affiliation: Department of Surgery, University of Melbourne, Parkville, Victoria, 3010, Australia
Intensive Care
School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, Victoria, 3800, Australia
Eastern Health, Arnold Street, Box Hill, Victoria, 3128, Australia
Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, 5 Arnold St, Box Hill, Victoria, 3128, Australia
Centre for Quality and Patient Safety Research - Eastern Health Partnership, 2/5 Arnold St, Box Hill, Victoria, 3128, Australia
Deakin University: School of Nursing and Midwifery & Institute for Health Transformation, 1 Gheringhap St, Geelong, Victoria, 3220, Australia
Deakin University: Centre for Quality and Patient Safety Research, 1 Gheringhap St, Geelong, Victoria, 3220, Australia
Deakin University: Deakin Learning Futures, Office of the Deputy Vice Chancellor (Education), 1 Gheringhap St, Geelong, Victoria, 3220, Australia
Issue Date: 9-Mar-2021
metadata.dc.date: 2021-03-09
Publication information: Australian Critical Care 2021; online first: 9 March
Abstract: Medical emergency team (MET) activation criteria are sometimes modified to minimise unnecessary MET calls in patients who have chronic physiological derangements, have limitation of medical treatment orders in place, or have recently received treatment for clinical deterioration. However, the safety implications of modifying MET activation criteria are poorly understood. The aim of the study was to examine the safety of modifying MET activation criteria. Specifically, we aimed to examine the frequency and nature of modifications to MET activation criteria and compare characteristics and outcomes of patients with and without modifications to MET activation criteria. This was a point prevalence study using a retrospective medical record audit. Patients admitted to 14 wards on November 7, 2018, at two acute-care hospitals of one health service in Melbourne, Australia, were included (N = 430). Data were analysed using descriptive and inferential statistics. The main outcome measures included frequency and nature of modifications to MET activation criteria on a specified date, MET calls, intensive care unit admission, in-hospital cardiac arrest, and in-hospital death. Amongst 430 inpatients, there were 30 modifications to MET activation criteria in 26 (6.0%) patients. All modifications were intended to trigger METs at more extreme levels of physiological derangement. Most modifications pertained to tachypnoea (26.7%; n = 8/30) and bradycardia (23.3%; n = 7/30). Patients with modifications were more likely to have documented physiological deterioration that fulfilled MET (47.8%, n = 11; p < 0.001) or pre-MET (87.0%, n = 20; p < 0.001) criteria in the preceding 24-h period than patients without modifications. Of patients with modifications, none were admitted to an intensive care unit, had a cardiac arrest, or died in the hospital. There were no differences in hospital length of stay or discharge destination between patients with and without modifications. In this point prevalence study, modifications to MET activation criteria were infrequent and not associated with negative patient safety outcomes.
URI: https://ahro.austin.org.au/austinjspui/handle/1/26041
DOI: 10.1016/j.aucc.2021.01.004
PubMed URL: 33712324
ISSN: 1036-7314
Type: Journal Article
Subjects: Clinical deterioration
Critical care
Hospital rapid response team
Patient safety
Retrospective studies
Appears in Collections:Journal articles

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