Outreach Teams (outreach + team)

Distribution by Scientific Domains

Kinds of Outreach Teams

  • care outreach team
  • critical care outreach team


  • Selected Abstracts


    Implementing the severe sepsis care bundles outside the ICU by outreach

    NURSING IN CRITICAL CARE, Issue 5 2007
    Chris Carter
    Abstract Sepsis is not a new challenge facing the health care team, it remains a complex disease, which is difficult to identify and treat. Mortality from sepsis remains high and continues to be a common cause of death among critically ill patients, despite advances in critical care. Sepsis accounts for an estimated 27% of all intensive care admissions in England, Wales and Northern Ireland, and accounted for 46% of all intensive care bed days. Recent research studies and the surviving sepsis campaign have shown that identifying and providing key interventions to patients with severe sepsis and septic shock prior to their admission to the intensive care unit significantly improve outcomes. The aim of this paper was to identify how the Critical Care Outreach Team at one local hospital implemented the severe sepsis resuscitation care bundle for patients in the emergency department (ED) and on the general wards. It will include a presentation on the various ways the team raised the profile of severe sepsis and the care bundle at hospital and at national level. It also includes audit data that have been collected. The results showed that if the resuscitation care bundle was implemented within the first 24 h of hospital admission, mortality was 29%, whereas if the care bundle was instigated after this time mortality was more than at 49%. Audit data showed that the commonest sign of severe sepsis seen in patients in the ED and on wards was tachypnoea. This article discusses the successful implementation of the severe sepsis resuscitation care bundle and the positive impact an Outreach team can have in changing practice in the way patients are managed with severe sepsis. The audit data support the need for regular physiological observations and the use of a Patient At Risk Trigger scoring tool to identify patients at risk of deterioration. This allows referral to the Outreach team, who assess the patient and if appropriate initiate the care bundle. [source]


    GOAL ATTAINMENT SCALING: AN EFFECTIVE OUTCOME MEASURE FOR RURAL AND REMOTE HEALTH SERVICES

    AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 5 2002
    Ruth Cox
    ABSTRACT: The aim of this paper is to demonstrate the utility of Goal Attainment Scaling (GAS) as an effective, multidisciplinary measure of client outcomes for rural and remote health services. Goal Attainment Scaling was adopted by the Spinal Outreach Team (SPOT) as a client-focussed evaluation tool, as it is sensitive to the individual nature of clients' presenting issues and the multidisciplinary focus of the team. It enables individualised goals to be set on a five-point scale. Goal Attainment Scaling was introduced to the SPOT service after a pilot trial established guidelines for its effective implementation. An ongoing review process ensures that goal scaling remains realistic and relevant. Service outcomes can be effectively summarised using a frequency distribution of GAS scores. One of the important benefits of GAS is its facilitation of collaborative goal setting between clinician and client. Goal Attainment Scaling is recommended to rural and remote multidisciplinary health services because of its ability to summarise outcomes from heterogeneous service activities. [source]


    Implementing the severe sepsis care bundles outside the ICU by outreach

    NURSING IN CRITICAL CARE, Issue 5 2007
    Chris Carter
    Abstract Sepsis is not a new challenge facing the health care team, it remains a complex disease, which is difficult to identify and treat. Mortality from sepsis remains high and continues to be a common cause of death among critically ill patients, despite advances in critical care. Sepsis accounts for an estimated 27% of all intensive care admissions in England, Wales and Northern Ireland, and accounted for 46% of all intensive care bed days. Recent research studies and the surviving sepsis campaign have shown that identifying and providing key interventions to patients with severe sepsis and septic shock prior to their admission to the intensive care unit significantly improve outcomes. The aim of this paper was to identify how the Critical Care Outreach Team at one local hospital implemented the severe sepsis resuscitation care bundle for patients in the emergency department (ED) and on the general wards. It will include a presentation on the various ways the team raised the profile of severe sepsis and the care bundle at hospital and at national level. It also includes audit data that have been collected. The results showed that if the resuscitation care bundle was implemented within the first 24 h of hospital admission, mortality was 29%, whereas if the care bundle was instigated after this time mortality was more than at 49%. Audit data showed that the commonest sign of severe sepsis seen in patients in the ED and on wards was tachypnoea. This article discusses the successful implementation of the severe sepsis resuscitation care bundle and the positive impact an Outreach team can have in changing practice in the way patients are managed with severe sepsis. The audit data support the need for regular physiological observations and the use of a Patient At Risk Trigger scoring tool to identify patients at risk of deterioration. This allows referral to the Outreach team, who assess the patient and if appropriate initiate the care bundle. [source]


    A Randomized, Controlled Trial of Comprehensive Geriatric Assessment and Multidisciplinary Intervention After Discharge of Elderly from the Emergency Department,The DEED II Study

    JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2004
    FRACP, Gideon A. Caplan MBBS
    Objectives: To study the effects of comprehensive geriatric assessment (CGA) and multidisciplinary intervention on elderly patients sent home from the emergency department (ED). Design: Prospective, randomized, controlled trial with 18 months of follow-up. Setting: Large medical school,affiliated public hospital in an urban setting in Sydney, Australia. Participants: A total of 739 patients aged 75 and older discharged home from the ED were randomized into two groups. Intervention: Patients randomized to the treatment group underwent initial CGA and were followed at home for up to 28 days by a hospital-based multidisciplinary outreach team. The team implemented or coordinated recommendations. The control group received usual care. Measurements: The primary outcome measure was all admissions, to the hospital within 30 days of the initial ED visit. Secondary outcome measures were elective and emergency admissions, and nursing home admissions and mortality. Additional outcomes included physical function (Barthel Index (total possible score=20) and instrumental activities of daily living (/12) and cognitive function (mental status questionnaire (/10)). Results: Intervention patients had a lower rate of all admissions to the hospital during the first 30 days after the initial ED visit (16.5% vs 22.2%; P=.048), a lower rate of emergency admissions during the 18-month follow-up (44.4% vs 54.3%; P=.007), and longer time to first emergency admission (382 vs 348 days; P=.011). There was no difference in admission to nursing homes or mortality. Patients randomized to the intervention group maintained a greater degree of physical and mental function (Barthel Index change from baseline at 6 months: ,0.25 vs ,0.75; P<.001; mental status questionnaire change from baseline at 12 months: ,0.21 vs ,0.64; P<.001). Conclusion: CGA and multidisciplinary intervention can improve health outcomes of older people at risk of deteriorating health and admission to hospital. Patients aged 75 and older should be referred for CGA after an ED visit. [source]


    Crossing boundaries, re-defining care: the role of the critical care outreach team

    JOURNAL OF CLINICAL NURSING, Issue 3 2002
    MAUREEN COOMBS BSc MSc PhD RN
    ,,There is clear indication that both government and professional policy in the United Kingdom supports a radical change in the role of healthcare practitioners, with a move towards a patient-focused service delivered by clinical teams working effectively together. ,,Recent health service imperatives driving the agenda for flexible clinical teams have occurred simultaneously with an increased public and political awareness of deficits in availability of critical care services. ,,Against this policy backdrop, working across professional and organizational boundaries is fundamental to supporting quality service improvements. In the acute care sector, the development of critical care outreach teams is an innovation that seeks to challenge the traditional support available for sick ward patients. ,,Activity data and observations from the first 6-month evaluation of two critical care outreach teams identify the need for clinical support and education offered by critical care practitioners to ward-based teams. ,,The experiences from such flexible clinical teams provides a foundation from which to explore key issues for intradisciplinary and interdisciplinary working across clinical areas and organizational boundaries. ,,Adopting innovative approaches to care delivery, such as critical care outreach teams, can enable clinical teams and NHS trusts to work together to improve the quality of care for acutely ill patients, support clinical practitioners working with this client group, and develop proactive service planning. [source]


    Nurses' role in detecting deterioration in ward patients: systematic literature review

    JOURNAL OF ADVANCED NURSING, Issue 10 2009
    Mandy Odell
    Abstract Title.,Nurses' role in detecting deterioration in ward patients: systematic literature review. Aim., This paper is a report of a review conducted to identify and critically evaluate research investigating nursing practice in detecting and managing deteriorating general ward patients. Background., Failure to recognize or act on deterioration of general ward patients has resulted in the implementation of early warning scoring systems and critical care outreach teams. The evidence of effectiveness of these systems is unclear. Possible mechanisms for low effectiveness may be inconsistent recording of patient observations by ward staff, or inconsistent application of ,calling criteria' for outreach teams, even when observations have been recorded. Methods., The literature was searched between 1990 and 2007 using four sources: electronic databases, reference lists, key reports and experts in the field. Three broad search categories were used: nursing observations, physiological deterioration and general ward patients. All research designs describing nursing observations (vital signs) on deteriorating adult patients in general hospital wards were included. Results., Fourteen studies met the inclusion and quality criteria. The findings were grouped into four main themes: recognition; recording and reviewing; reporting; and responding and rescuing. The main findings suggest that intuition plays an important part in nurses' detection of deterioration, and vital signs are used to validate intuitive feelings. The process is highly complex and influenced by many factors, including the experience and education of bedside nurses and their relationship with medical staff. Conclusion., Greater understanding of the context within which deterioration is detected and reported will facilitate the design of more effective education and support systems. [source]


    Crossing boundaries, re-defining care: the role of the critical care outreach team

    JOURNAL OF CLINICAL NURSING, Issue 3 2002
    MAUREEN COOMBS BSc MSc PhD RN
    ,,There is clear indication that both government and professional policy in the United Kingdom supports a radical change in the role of healthcare practitioners, with a move towards a patient-focused service delivered by clinical teams working effectively together. ,,Recent health service imperatives driving the agenda for flexible clinical teams have occurred simultaneously with an increased public and political awareness of deficits in availability of critical care services. ,,Against this policy backdrop, working across professional and organizational boundaries is fundamental to supporting quality service improvements. In the acute care sector, the development of critical care outreach teams is an innovation that seeks to challenge the traditional support available for sick ward patients. ,,Activity data and observations from the first 6-month evaluation of two critical care outreach teams identify the need for clinical support and education offered by critical care practitioners to ward-based teams. ,,The experiences from such flexible clinical teams provides a foundation from which to explore key issues for intradisciplinary and interdisciplinary working across clinical areas and organizational boundaries. ,,Adopting innovative approaches to care delivery, such as critical care outreach teams, can enable clinical teams and NHS trusts to work together to improve the quality of care for acutely ill patients, support clinical practitioners working with this client group, and develop proactive service planning. [source]


    Physiological risk factors, early warning scoring systems and organizational changes

    NURSING IN CRITICAL CARE, Issue 5 2007
    Carolyn C Johnstone
    Abstract Currently, medical and surgical wards tend to have a higher number of sicker and more dependent patients. There is also a growing recognition that several indicators of acute deterioration are being missed, leading to adverse consequences for the patients. As a result, many initiatives have been designed to try to reduce these consequences, including the development of early warning scoring or track and trigger systems and medical response and critical care outreach teams. This paper briefly discusses the risk factors associated with acute deterioration, the use of early warning scoring or track and trigger systems and the role of outreach teams. The aim of this paper is to discuss the development and subsequent implementation of early warning scoring systems (EWS) or track and trigger systems. It will also discuss the associated organizational changes; the main organizational change discussed will be the introduction outreach teams. For this paper, a pragmatic search strategy was implemented using the following terms: early warning score and scoring, track and trigger systems, decision-making tools, critical care outreach and medical emergency teams. The databases used included CINHAL (1997,2007), Medline, Blackwell Synergy and Science Direct, as these would enable the retrieval of relevant literature in the area of triggering of response to acute deterioration in clinical condition. A 10-year limit was initially set, although review of the literature identified resulted in a widening of this to include some of the relevant (and occasionally more dated) literature referred to in these papers. A total of 645 were accessed; of these 135 were retrieved as they appeared to meet the inclusion criteria, but only 35 have been included in this review. The term decision-making tools accounted for the largest number (500), but most of these were irrelevant. EWS are not always used to their full potential, raising the question of their impact. The impact of outreach teams and medical emergency teams has yet to be fully defined. For clinical practice, this means that care must be taken when developing and implementing these changes. The rigour of the development process needs to be considered along with reflection upon how to best meet local requirements. [source]