RESUMO
Hundreds of lives are now being saved in hospitals across the country with the use of rapid response teams. These teams are composed of clinicians who bring critical care expertise to the patient bedside. The purpose of these teams is to assess and stabilize the patient, assist with communication among the interdisciplinary care providers, educate and support the staff caring for the patient, and assist with transfer of the patient if necessary. Research has shown that, with successful implementation of a rapid response team, the percent of codes and mortality rates decrease. The purpose of this study was to evaluate the effectiveness of implementing a rapid response team at 1 medical center. The results from the study demonstrated a decrease in the percent of codes outside the critical care units. However, it did not show a decrease in overall mortality rates for the patients. Data review will continue as we strive to improve our overall mortality rates while maintaining a decrease in the amount of codes.
Assuntos
Reanimação Cardiopulmonar , Cuidados Críticos/organização & administração , Parada Cardíaca/terapia , Equipe de Assistência ao Paciente/organização & administração , Idoso , Reanimação Cardiopulmonar/métodos , Reanimação Cardiopulmonar/enfermagem , Coleta de Dados , Emergências/epidemiologia , Emergências/enfermagem , Feminino , Parada Cardíaca/mortalidade , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa em Avaliação de Enfermagem , Cultura Organizacional , Avaliação de Resultados em Cuidados de Saúde , Comitê de Profissionais/organização & administração , Avaliação de Programas e Projetos de Saúde , Gestão da Segurança , Estações do Ano , South Carolina/epidemiologia , Taxa de Sobrevida , Gestão da Qualidade TotalAssuntos
Ritmo Circadiano , Complicações do Diabetes/metabolismo , Complicações do Diabetes/terapia , Hiperglicemia/metabolismo , Hiperglicemia/terapia , Insulina/análogos & derivados , Automonitorização da Glicemia/métodos , Ritmo Circadiano/fisiologia , Relação Dose-Resposta a Droga , Glucagon/metabolismo , Hormônio do Crescimento Humano/metabolismo , Humanos , Hidrocortisona/metabolismo , Hiperglicemia/etiologia , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Insulina Glargina , Insulina de Ação Prolongada , Metformina/uso terapêutico , Somatomedinas/metabolismo , Fatores de TempoRESUMO
PURPOSES: To review current data regarding the known pathophysiology of insulin resistance and its associated sequelae related to cardiovascular risk, to discuss the current measures for insulin sensitivity and studies associated with measures of insulin resistance, and to summarize the impact of insulin resistance. DATA SOURCES: CINAHL, Health and Wellness Resource Center, and Medline. FINDINGS: Insulin resistance yields a diminished sensitivity of key target cells to the actions of insulin and is present early in the course of insulin resistance syndrome, also known as metabolic syndrome, leading to prediabetes and cardiovascular disease approximately 10 years before the diagnosis of type 2 diabetes. IMPLICATIONS FOR PRACTICE: Early identification of insulin-resistant individuals would allow extra time for preventive measures and may alter the progression of the development of associated cardiovascular risk. A recommendation for a treatment plan of identified insulin-resistant individuals is provided.