John Dixon

Graduation Semester and Year

2012

Language

English

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Nursing

Department

Nursing

First Advisor

Carolyn Cason

Abstract

Knowledge of how intrinsic present-on-admission patient factors such as age, gender, and pre-existing comorbid conditions contribute to patient risk during hospitalization is an important aspect for clinicians to consider when developing individualized plans of care based on patient needs. Health care providers could use such knowledge to screen and identify higher risk patients upon admission to the hospital. For those patients, the health care team could provide greater surveillance and vigilance in observation and monitoring. Such proactive interventions may reduce or avoid the occurrence of patient deterioration or need for a Rapid Response Team (RRT) intervention during hospitalization and thus, in turn, avoid patient harm, Failure To Rescue, and mortality. The significance and influence of intrinsic present-on-admission patient factors with patient risk for adverse outcomes has been established. The purpose of this exploratory study was to examine selected intrinsic present-on-admission patient factors among RRT and non-RRT patients and the associations of these factors with the risk for an RRT intervention while hospitalized. Based on studies done to date, there is a gap in the literature regarding patient present-on-admission factors, their association with needing an RRT intervention while hospitalized, and the level of influence on that risk. This study was a secondary analysis of existing data from a single medical center. Descriptive statistics and logistic regression were computed. Present-on-admission patient factors significantly associated with risk for an RRT intervention during hospitalization were identified. Results from this study need to be considered within the context of the limitations and unexpected findings need additional review and study. This study may represent an initial step forward in creating a possible predictive model in the future; however, at this time it is too early for healthcare practitioners to use this study's findings as further exploration, examination, development, testing, and validation are needed. Such a program of research carries the possibility of a present-on-admission risk prediction tool that could guide care decisions related to the magnitude of surveillance and vigilance a patient requires at the point of admission to the hospital and, in turn, may proactively prevent the need for an RRT event. This study's results have made an initial contribution to an existing gap in knowledge about intrinsic present-on-admission patient factors and their relationship to RRT risk.

Disciplines

Medicine and Health Sciences | Nursing

Comments

Degree granted by The University of Texas at Arlington

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