RSVP: a system for communication in hospital patients

Medical Assessment Unit, Portsmouth Hospitals NHS Trust and University of Portsmouth.
British journal of nursing (Mark Allen Publishing) 07/2008; 17(13):860-4. DOI: 10.12968/bjon.2008.17.13.30540
Source: PubMed


Communication failures are a prime cause of patient safety incidents. In a medical emergency, patient survival often depends on ward staff making an early and effective call for help. To improve communication with senior colleagues, ward staff need to create a picture that efficiently and reliably conveys their concerns so that they get the help that they need without delay. This can best be achieved though a structured call for help. The Reason-Story-Vital Signs-Plan system, used in the Acute Life-threatening Events--Recognition and Treatment (ALERT) course, is easy to remember in an emergency and includes the essential information enabling an experienced clinician to respond appropriate to a call for help from ward staff. The use of such a structured call for help could improve patient safety.

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    • "). In the sample, authors assert that ACU nurses do not communicate effectively or clearly enough (Featherstone et al., 2008). Even if they are aware that they need quantifiable evidence of patient deterioration to convince doctors (Johnstone et al., 2007; Featherstone et al., 2008; Cioffi et al., 2009), they use social or everyday language rather than medical language (Andrews and Waterman, 2005) and do not always communicate relevant or necessary information (Donohue and Endacott, 2010). "
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    ABSTRACT: AimTo explore the variations between acute care and intensive care nurses' understanding of patient deterioration according to their use of this term in published literature.Background Evidence suggests that nurses on wards do not always recognize and act upon patient deterioration appropriately. Even if resources exist to call for intensive care nurses' help, acute care nurses use them infrequently and the problem of unattended patient deterioration remains.DesignDimensional analysis was used as a framework to analyze papers retrieved in a nursing-focused database.MethodA thematic analysis of 34 papers (2002–2012) depicting acute care and intensive care unit nurses' perspectives on patient deterioration was conducted.FindingsNo explicit definition of patient deterioration was retrieved in the papers. There are variations between acute care and intensive care unit nurses' accounts of this concept, particularly regarding the validity of patient deterioration indicators. Contextual factors, processes and consequences are also explored.Conclusions From the perspectives of acute care and intensive care nurses, patient deterioration can be defined as an evolving, predictable and symptomatic process of worsening physiology towards critical illness. Contextual factors relating to acute care units (ACU) appear as barriers to optimal care of the deteriorating patient. This work can be considered as a first effort in modelling the concept of patient deterioration, which could be specific to ACU.Relevance to clinical practiceThe findings suggest that it might be relevant to include subjective indicators of patient deterioration in track and trigger systems and educational efforts. Contextual factors impacting care for the deteriorating patient could be addressed in further attempts to deal with this issue.
    Nursing in Critical Care 09/2014; DOI:10.1111/nicc.12114 · 0.65 Impact Factor
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    • "In this evaluation the majority of course participants claimed that their ability to communicate with others had improved or would improve after this course. Much work is published on the communication difficulties between doctors and nurses specifically in this context (Snelgrove and Hughes, 2002; Leonard et al., 2004; Endacott et al., 2007; Manser, 2009) and has led to the generation of a number of specific 'communication tools', namely SBAR and RSVP (Reason-Story-Vital signs-Plan) (Haig et al., 2006; Featherstone et al., 2008). Nursing and medical training are often almost entirely separate and medical and nursing knowledge is deeply rooted in the hierarchical divisions of labour, impacted on by gender and the inequalities in power between the professions (Snelgrove and Hughes, 2002). "
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    ABSTRACT: Issues around the deterioration of hospitalised children are known: the failure to observe and monitor patients adequately, a failure to recognise the deteriorating patient, a failure to communicative effectively within the healthcare team and a failure to respond appropriately or in a timely manner (Pearson, 2008; NPSA, 2009). In response to this, a new 1-day course called RESPOND (Recognising Signs of Paediatric hOspital iNpatients Deterioration) was developed. To describe the development of the RESPOND course and present a preliminary evaluation of the first four courses. A written postcourse survey was completed by participants (junior doctors, medical students, nurses and health care assistants) immediately after the course and an electronic survey completed three months later in a large children's hospital in the North West of England. Data were analysed descriptively and by simple thematic analysis of free text responses. Sixty-five participants undertook the RESPOND course over four separate days. Overwhelmingly participants found the course positive, with the most frequently cited benefit being improved multidisciplinary communication. Despite a poor response to the second survey, 18% (12 of 65) of respondents remained positive about the impact of the course. This preliminary evaluation combined with a reduction in hospital cardiac arrest rates suggest that the multiprofessional RESPOND course (in conjunction with an early warning tool and response system) is successful as part of a targeted strategy to promote patient safety within a children's hospital.
    Nursing in Critical Care 10/2013; 19(4). DOI:10.1111/nicc.12050 · 0.65 Impact Factor
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    ABSTRACT: The 'chain of survival' has been a useful tool for improving the understanding of, and the quality of the response to, cardiac arrest for many years. In the 2005 European Resuscitation Council Guidelines the importance of recognising critical illness and preventing cardiac arrest was highlighted by their inclusion as the first link in a new four-ring 'chain of survival'. However, recognising critical illness and preventing cardiac arrest are complex tasks, each requiring the presence of several essential steps to ensure clinical success. This article proposes the adoption of an additional chain for in-hospital settings--a 'chain of prevention'--to assist hospitals in structuring their care processes to prevent and detect patient deterioration and cardiac arrest. The five rings of the chain represent 'staff education', 'monitoring', 'recognition', the 'call for help' and the 'response'. It is believed that a 'chain of prevention' has the potential to be understood well by hospital clinical staff of all grades, disciplines and specialties, patients, and their families and friends. The chain provides a structure for research to identify the importance of each of the various components of rapid response systems.
    Resuscitation 09/2010; 81(9):1209-11. DOI:10.1016/j.resuscitation.2010.04.017 · 4.17 Impact Factor
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