Rapid Response Systems Reduce In-Hospital Cardiopulmonary Arrest: A Pilot Study and Motivation for a Nationwide Survey
- Author:
Yeonhee PARK
1
;
Jong Joon AHN
;
Byung Ju KANG
;
Young Seok LEE
;
Sang Ook HA
;
Jin Soo MIN
;
Woo Hyun CHO
;
Se Hee NA
;
Dong Hyun LEE
;
Seung Yong PARK
;
Goo Hyeon HONG
;
Hyun Jung KIM
;
Sangwoo SHIM
;
Jung Hyun KIM
;
Seok Jeong LEE
;
So Young PARK
;
Jae Young MOON
Author Information
- Publication Type:Original Article
- Keywords: in-hospital cardiopulmonary arrest; patient safety; quality of health care; rapid response systems
- MeSH: Adult; Cardiopulmonary Resuscitation; Heart Arrest; Hospitals, High-Volume; Humans; Incidence; Motivation; Patient Safety; Patients' Rooms; Pilot Projects; Quality of Health Care; Retrospective Studies; Tertiary Care Centers
- From:The Korean Journal of Critical Care Medicine 2017;32(3):231-239
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Early recognition of the signs and symptoms of clinical deterioration could diminish the incidence of cardiopulmonary arrest. The present study investigates outcomes with respect to cardiopulmonary arrest rates in institutions with and without rapid response systems (RRSs) and the current level of cardiopulmonary arrest rate in tertiary hospitals. METHODS: This was a retrospective study based on data from 14 tertiary hospitals. Cardiopulmonary resuscitation (CPR) rate reports were obtained from each hospital to include the number of cardiopulmonary arrest events in adult patients in the general ward, the annual adult admission statistics, and the structure of the RRS if present. RESULTS: Hospitals with RRSs showed a statistically significant reduction of the CPR rate between 2013 and 2015 (odds ratio [OR], 0.731; 95% confidence interval [CI], 0.577 to 0.927; P = 0.009). Nevertheless, CPR rates of 2013 and 2015 did not change in hospitals without RRS (OR, 0.988; 95% CI, 0.868 to 1.124; P = 0.854). National university-affiliated hospitals showed less cardiopulmonary arrest rate than private university-affiliated in 2015 (1.92 vs. 2.40; OR, 0.800; 95% CI, 0.702 to 0.912; P = 0.001). High-volume hospitals showed lower cardiopulmonary arrest rates compared with medium-volume hospitals in 2013 (1.76 vs. 2.63; OR, 0.667; 95% CI, 0.577 to 0.772; P < 0.001) and in 2015 (1.55 vs. 3.20; OR, 0.485; 95% CI, 0.428 to 0.550; P < 0.001). CONCLUSIONS: RRSs may be a feasible option to reduce the CPR rate. The discrepancy in cardiopulmonary arrest rates suggests further research should include a nationwide survey to tease out factors involved in in-hospital cardiopulmonary arrest and differences in outcomes based on hospital characteristics.
