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Failure to Rescue in the Nursing Profession
9
Failure to Rescue in the Nursing Profession
Angela Pullen and Cassie Martinez
CHECKLIST FOR CHANGE IN PATIENT CONDITION
references
conclusion
Kendall-Gallagher, D., Aiken, L. H., Sloane, D. M., & Cimiotti, J. P. (2011). Nurse Specialty
Certification, Inpatient Mortality, and Failure to Rescue. Journal Of Nursing Scholarship, 43(2),
188-194. doi:10.1111/j.1547-5069.2011.01391.x
Shever, L. L. (2011). The impact of nursing surveillance on failure to rescue. Research & Theory
For Nursing Practice, 25(2), 107-126. doi:10.1891/1541-6577.25.2.107
Young-Xu, Y., Fore, A., Metcalf, A., Payne, K., Neily, J., & Sculli, G. (2013). Using Crew Resource Management and a 'Read-and-Do Checklist' to Reduce Failure-to-Rescue Events on a Step-Down Unit. American Journal of Nursing, 113(9), 51-57.
ACTIVITY & SHORT YOU TUBE VIDEO
**CHANGES-NEW, ACUTE, SYMPTOMATIC, OBSERVED**
Check the patient:*responsive?
*breathing?
*pulse?
NO=Begin BLS & call a code
YES=Do a quick assessment.
*airway-reposition, suction
*breathing-^HOB, O2, call RT
*circulation-VS, ECG, IV access
*LOC-GCS, pupils
No improvement or needs intervention= call charge RN & Dr
Does the patient need RRT intervention?
*Significant changes in LOC/VS?
*Response to interventions poor?
*Do you have a gut feeling or uncomfortable with situation?
*More resources needed?
YES=call the RRT
NO=call Dr for further orders
May need to call RRT if staff deems necessary.
support from evidenced based practice
*Experience is not a substitute for improving nurse education levels (ex: BSN).
Know RRT Criteria
*RR, O2 Sat, pH, PO2,PCO2, pulmonary edema, HR, BP, ST segment changes, arrhythmia on monitor, neuro changes, electrolytes, glucose, significant bleeding, uncontrolled pain
*Checking on each patient 12 + times a day decreases the odds of failure-to-rescue. (Consider variables like RT, techs, PT/This does not substitute observation by the RN but it does increase the chances of a change being noticed and reported for timely interventions.)
risk factors & complications
*An additional patient to a nurse's workload increases odds of failure-to-rescue by 7%.
RISK FACTORS
*orthostatic hypotension
*physical impairments
*ambulation difficulties
*pt can/does use call light
*elimination habits
QSEN PROJECT
quality IMPROVEMENT
& SAFETY
COMPLICATIONS
*cardiac decline/arrest
*tissue organ injury
*pneumothorax
*respiratory decline/arrest
*venous (DVT)
*CVA
*death
Failure to rescue is defined as not activating the proper interventions that result complications that lead the death of a patient after that patient was judged healthy enough for surgery/treatment.