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  • 1.
    Alshehri, Badryah
    et al.
    Sophiahemmet Högskola.
    Klarare Ljungberg, Anna
    Sophiahemmet Högskola.
    Rüter, Anders
    Sophiahemmet Högskola.
    Medical-surgical nurses' experiences of calling a rapid response team in a hospital setting: a literature review2015Ingår i: Middle East Journal of Nursing, ISSN 1834-8742, Vol. 9, nr 3, s. 3-23Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The rapid response team (RRT) decreases rates of mortality and morbidity in hospital and decreases the number of patient readmissions to the intensive care unit. This team helps patients before they have any signs of deterioration related to cardiac or pulmonary arrest. The aim of the RRT is to accelerate recognition and treatment of a critically ill patient. In addition, in order to be ready to spring into action without delay, the RRT must be on site and accessible, with good skills and training for emergency cases. It has been reported that many hospitals are familiar with the concept of RRTs. There is a difference between this team and a cardiac arrest team, since the RRT intervenes before a patient experiences cardiac or respiratory arrest.

    Aim: To describe current knowledge about medical-surgical nurses' experiences when they call an RRT to save patients' lives.

    Method: The method used by the author was a literature review. The PubMed search database was used and 15 articles were selected, all of which were primary academic studies. Articles were analysed and classified according to specified guidelines; only articles of grades I and II were included.

    Results: Years of experience and qualifications characterise the ability of a medical-surgical nurse to decide whether or not to call the RRT. Knowledge and skills are also important; some hospitals provide education about RRTs, while others do not. Teamwork between bedside nurses and RRTs is effective in ensuring quality care. There are some challenges that might affect the outcome of patient care: The method of communication is particularly important in highlighting what nurses need RRTS to do in order to have fast intervention.

    Conclusion: Medical-surgical nurses call RRTs to help save patients' lives, and depend on their experience when they call RRTs. Both medical-surgical nurses and RRTs need to collaborate during the delivery of care to the patient. Good knowledge and communication skills are important in delivering fast intervention to a critically ill patient, so that deteriorating clinical signs requiring intervention can be identified.

  • 2. Debacker, Michel
    et al.
    Hubloue, Ives
    Dhondt, Erwin
    Rockenschaub, Gerald
    Rüter, Anders
    Sophiahemmet Högskola.
    Codreanu, Tudor
    Koenig, Kristi L
    Schultz, Carl
    Peleg, Kobi
    Halpern, Pinchas
    Stratton, Samuel
    Della Corte, Francesco
    Delooz, Herman
    Ingrassia, Pier Luigi
    Colombo, Davide
    Castrèn, Maaret
    Utstein-style template for uniform data reporting of acute medical response in disasters2012Ingår i: PLoS currents, ISSN 2157-3999, Vol. 4, s. e4f6cf3e8df15a-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: In 2003, the Task Force on Quality Control of Disaster Management (WADEM) published guidelines for evaluation and research on health disaster management and recommended the development of a uniform data reporting tool. Standardized and complete reporting of data related to disaster medical response activities will facilitate the interpretation of results, comparisons between medical response systems and quality improvement in the management of disaster victims.

    METHODS: Over a two-year period, a group of 16 experts in the fields of research, education, ethics and operational aspects of disaster medical management from 8 countries carried out a consensus process based on a modified Delphi method and Utstein-style technique.

    RESULTS: The EMDM Academy Consensus Group produced an Utstein-style template for uniform data reporting of acute disaster medical response, including 15 data elements with indicators, that can be used for both research and quality improvement.

    CONCLUSION: It is anticipated that the Utstein-style template will enable better and more accurate completion of reports on disaster medical response and contribute to further scientific evidence and knowledge related to disaster medical management in order to optimize medical response system interventions and to improve outcomes of disaster victims.

  • 3. Jabar, A
    et al.
    Wallis, L A
    Rüter, Anders
    Sophiahemmet Högskola.
    Smith, W P
    Modified Delphi study to determine optimal data elements for inclusion in an emergency management database system = Enquête Delphi modifiée afin de déterminer les éléments de données optimales en vue de leur intégration à un système de base de données de gestion des urgences2012Ingår i: African Journal of Emergency Medicine, ISSN 2211-419X, Vol. 2, nr 1, s. 13-19Artikel i tidskrift (Refereegranskat)
  • 4. Jokela, Jorma
    et al.
    Rådestad, Monica
    Gryth, Dan
    Nilsson, Helené
    Rüter, Anders
    Sophiahemmet Högskola.
    Svensson, Leif
    Harkke, Ville
    Luoto, Markku
    Castrén, Maaret
    Increased situation awareness in major incidents - radio frequency identification (RFID) technique: a promising tool2012Ingår i: Prehospital and Disaster Medicine, ISSN 1049-023X, EISSN 1945-1938, Vol. 1, s. 1-7Artikel i tidskrift (Refereegranskat)
  • 5.
    Murphy, Jason
    et al.
    Sophiahemmet Högskola.
    Rådestad, Monica
    Kurland, Lisa
    Jirwe, Maria
    Sophiahemmet Högskola.
    Djalali, Ahmadreza
    Rüter, Anders
    Sophiahemmet Högskola.
    Emergency department registered nurses' disaster medicine competencies. An exploratory study utilizing a modified Delphi technique2018Ingår i: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, artikel-id S1755-599X(18)30135-6Artikel i tidskrift (Refereegranskat)
  • 6. Rådestad, Monica
    et al.
    Jirwe, Maria
    Castrén, Maaret
    Svensson, Leif
    Gryth, Dan
    Rüter, Anders
    Sophiahemmet Högskola.
    Essential key indicators for disaster medical response suggested to be included in a national uniform protocol for documentation of major incidents: a Delphi study2013Ingår i: Scandinavian journal of trauma, resuscitation and emergency medicine, ISSN 1757-7241, Vol. 21, s. 68-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Registration of data from a major incident or disaster serves several purposes such as to record data for evaluation of response as well as for research. Data needed can often be retrieved after an incident while other must be recorded during the incident. There is a need for a consensus on what is essential to record from a disaster response. The aim of this study was to identify key indicators essential for initial disaster medical response registration. By this is meant nationally accepted processes involved, from the time of the emergency call to the emergency medical communication centre until medical care is provided at the emergency department.

    METHODS: A three round Delphi study was conducted. Thirty experts with a broad knowledge in disaster and emergency response and medical management were invited. In this study we estimated 30 experts to be approximately one third of the number in Sweden eligible for recruitment. Process, structure and outcome indicators for the initial disaster medical response were identified. These were based on previous research and expressed as statements and were grouped into eight categories, and presented to the panel of experts. The experts were instructed to score each statement, using a five point Likert scale, and were also invited to include additional statements. Statements reaching a predefined consensus level of 80% were considered as essential to register.

    RESULTS: In total 97 statements were generated, 77 statements reached consensus. The 77 statements covered parts of all relevant aspects involved in the initial disaster medical response. The 20 indicators that did not reach consensus mostly concerned patient related times in hospital, types of support systems and security for health care staff.

    CONCLUSIONS: The Delphi technique can be used for reaching consensus of data, comprising process, structure and outcome indicators, identified as essential for recording from major incidents and disasters.

  • 7. Rådestad, Monica
    et al.
    Lennquist Montán, Kristina
    Rüter, Anders
    Sophiahemmet Högskola.
    Castrén, Maaret
    Svensson, Leif
    Gryth, Dan
    Fossum, Bjöörn
    Sophiahemmet Högskola.
    Attitudes Towards and Experience of the Use of Triage Tags in Major Incidents: A Mixed Method Study2016Ingår i: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 31, nr 4, s. 376-85Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction Disaster triage is the allocation of limited medical resources in order to optimize patient outcome. There are several studies showing the poor use of triage tagging, but there are few studies that have investigated the reasons behind this. The aim of this study was to explore ambulance personnel attitude towards, and experiences of, practicing triage tagging during day-to-day management of trauma patients, as well as in major incidents (MIs).

    METHODS: A mixed method design was used. The first part of the study was in the form of a web-survey of attitudes answered by ambulance personnel. The question explored was: Is it likely that systems that are not used in everyday practice will be used during MIs? Two identical web-based surveys were conducted, before and after implementing a new strategy for triage tagging. This strategy consisted of a time-limited triage routine where ambulance services assigned triage category and applied triage tags in day-to-day trauma incidents in order to improve field triage. The second part comprised three focus group interviews (FGIs) in order to provide a deeper insight into the attitudes towards, and experience of, the use of triage tags. Data were analyzed using qualitative content analysis.

    RESULTS: The overall finding was the need for daily routine when failure in practice. Analysis of the web-survey revealed three changes: ambulance personnel were more prone to use tags in minor accidents, the sort scoring system was considered to be more valuable, but it also was more time consuming after the intervention. In the analysis of FGIs, four categories emerged that describe the construction of the overall category: perceived usability, daily routine, documentation, and need for organizational strategies.

    CONCLUSION: Triage is part of the foundation of ambulance skills, but even so, ambulance personnel seldom use this in routine practice. They fully understand the benefit of accurate triage decisions, and also that the use of a triage algorithm and color coded tags is intended to make it easier and more secure to perform triage. However, despite the knowledge and understanding of these benefits, sparse incidents and infrequent exercises lead to ambulance personnel's uncertainty concerning the use of triage tagging during a MI and will therefore, most likely, avoid using them. Rådestad M , Lennquist Montán K , Rüter A , Castrén M , Svensson L , Gryth D , Fossum B . Attitudes towards and experience of the use of triage tags in major incidents: a mixed method study. Prehosp Disaster Med. 2016;31(4):1-10.

  • 8. Rådestad, Monica
    et al.
    Nilsson, Heléne
    Castrén, Maaret
    Svensson, Leif
    Rüter, Anders
    Sophiahemmet Högskola.
    Gryth, Dan
    Combining performance and outcome indicators can be used in a standardized way: a pilot study of two multidisciplinary, full-scale major aircraft exercises2012Ingår i: Scandinavian journal of trauma, resuscitation and emergency medicine, ISSN 1757-7241, Vol. 20, s. 58-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    ABSTRACT: BACKGROUND: Disaster medicine is a fairly young scientific discipline and there is a need for the development of new methods for evaluation and research. This includes full-scale disaster exercisers. A standardized concept on how to evaluate these exercises, could lead to easier identification of pitfalls caused by system-errors in the organization. The aim of this study was to demonstrate the feasibility of using a combination of performance and outcome indicators so that results can be compared in standardized full-scale exercises. METHODS: Two multidisciplinary, full-scale exercises were studied in 2008 and 2010. The panorama had the same setup. Sets of performance indicators combined with indicators for unfavorable patient outcome were recorded in predesigned templates. Evaluators, all trained in a standardized way at a national disaster medicine centre, scored the results on predetermined locations; at the scene, at hospital and at the regional command and control. RESULTS: All data regarding the performance indicators of the participants during the exercises were obtained as well as all data regarding indicators for patient outcome. Both exercises could therefore be compared regarding performance (processes) as well as outcome indicators. The data from the performance indicators during the exercises showed higher scores for the prehospital command in the second exercise 15 points and 3 points respectively. Results from the outcome indicators, patient survival and patient complications, demonstrated a higher number of preventable deaths and a lower number of preventable complications in the exercise 2010. In the exercise 2008 the number of preventable deaths was lower and the number of preventable complications was higher. CONCLUSIONS: Standardized multidisciplinary, full-scale exercises in different settings can be conducted and evaluated with performance indicators combined with outcome indicators enabling results from exercises to be compared. If exercises are performed in a standardized way, results may serve as a basis for lessons learned. Future use of the same concept using the combination of performance indicators and patient outcome indicators may demonstrate new and important evidence that could lead to new and better knowledge that also may be applied during real incidents.

  • 9.
    Rüter, Anders
    Sophiahemmet Högskola.
    Incident site command and control2013Ingår i: Disaster management: medical preparedness, response and homeland security / [ed] Rajesh Arora & Preeti Arora, Wallingford: CABI Publishing, 2013, s. 164-180Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 10.
    Rüter, Anders
    et al.
    Sophiahemmet Högskola.
    Kurland, Lisa
    Gryth, Dan
    Murphy, Jason
    Sophiahemmet Högskola.
    Rådestad, Monica
    Djalali, Ahmadreza
    Evaluation of Disaster Preparedness Based on Simulation Exercises: A Comparison of Two Models2016Ingår i: Disaster medicine and public health preparedness, ISSN 1938-744X, Vol. 10, nr 4, s. 544-548Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The objective of this study was to highlight 2 models, the Hospital Incident Command System (HICS) and the Disaster Management Indicator model (DiMI), for evaluating the in-hospital management of a disaster situation through simulation exercises.

    METHODS: Two disaster exercises, A and B, with similar scenarios were performed. Both exercises were evaluated with regard to actions, processes, and structures. After the exercises, the results were calculated and compared.

    RESULTS: In exercise A the HICS model indicated that 32% of the required positions for the immediate phase were taken under consideration with an average performance of 70%. For exercise B, the corresponding scores were 42% and 68%, respectively. According to the DiMI model, the results for exercise A were a score of 68% for management processes and 63% for management structure (staff skills). In B the results were 77% and 86%, respectively.

    CONCLUSIONS: Both models demonstrated acceptable results in relation to previous studies. More research in this area is needed to validate which of these methods best evaluates disaster preparedness based on simulation exercises or whether the methods are complementary and should therefore be used together.

  • 11. Östlund, Petra
    et al.
    Rüter, Anders
    Sophiahemmet Högskola.
    Franklin Larsson, Lise-Lotte
    Sophiahemmet Högskola.
    Patienters upplevelser av delaktighet i vården: En intervjustudie på en akutvårdsavdelning2016Konferensbidrag (Övrigt vetenskapligt)
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