ABSTRACT
OBJECTIVE: To determine the rate of adverse events and incidents occurring as a result of hospital staff leaving normal duties to attend medical emergency team (MET) calls. DESIGN, PARTICIPANTS AND SETTING: Single-centre, interview and questionnaire-based study of staff attending MET calls at a 650-bed university teaching hospital in Sydney, New South Wales, July to December 2013. MAIN OUTCOME MEASURE: The rate of adverse events and incidents directly related to MET staff leaving normal duties to attend MET calls. RESULTS: During the study period, 1490 structured interviews were conducted, and 279 written questionnaires were returned (overall response rate, 66.4%). There were no adverse events. There were 378 recorded incidents. The incident rate was 213.7 incidents per 1000 MET participant attendances (95% CI, 194.8-233.5), and 1.1 incidents per MET call. Using the severity assessment code, 99.5% of incidents were classified as minimum. The most commonly reported incidents were disruptions to normal duties, ward rounds, and patient reviews. Only 0.8% of incidents were reported on institutional incident reporting systems. CONCLUSION: Significant disruption to normal hospital routines and inconvenience to staff occurred, without causing major harm to patients, when MET staff temporarily left normal duties to attend MET calls. Normal hospital incident reporting systems cannot be used to monitor for these problems, as they are underreported.
Subject(s)
Hospital Rapid Response Team/statistics & numerical data , Medical Staff, Hospital , Nursing Staff, Hospital , Outcome Assessment, Health Care , Heart Arrest/epidemiology , Hospitals, Teaching , Hospitals, University , Humans , Interviews as Topic , New South Wales , Surveys and Questionnaires , Time Factors , WorkloadABSTRACT
BACKGROUND: Clinical emergency response systems such as medical emergency teams (MET) have been implemented in many hospitals worldwide, but the effect that these systems have on injuries to hospital staff is unknown. The objective of this study was to determine the rate and nature of injuries occurring in hospital staff attending MET calls. METHODS: This study was a prospective, observational study, using a structured interview, of 1265 MET call participants, in a 650 bed urban, teaching hospital. Data was collected on the number and the nature of injuries occurring in hospital staff attending MET calls. RESULTS: Over 131 days, 248 MET calls were made. An average of 8.1 staff participated in each MET call. The overall injury rate was 13 (95% confidence interval (CI) 7-20) per 1000 MET participant attendances, and 70 (95% CI 38-102) per 1000 MET calls. One injured participant required time off-work, an injury requiring time off-work rate of 1 (95% CI 0-4) per 1000 MET participant attendances, or 4 (95% CI 0-27) per 1000 MET calls. The relative risk of sustaining an injury if the MET participant performed chest compressions, contacted patient body fluids on clothing or protective equipment, without direct contact to skin or mucosa, or lifted the patient or a patient body part was 11.0 (95% CI 4.2-28.6), 8.7 (95% CI 3.4-22.0) and 5.5 (95% CI 2.1-14.2), respectively. CONCLUSION: The rate of injuries occurring to hospital staff attending MET calls is relatively low, and many injuries could be considered relatively minor.
