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Abstract
ABSTRACTBackground: Widespread implementation of rapid response (RR) systems positively impacts outcomes of clinically unstable hospitalized patients. Collaboration between bedside providers and specialized responding teams is crucial for effective functioning of RR system. Bedside, providers often harbor negative feelings about having to ‘call for help’ that could impact their active participation in RR.Objective: The objective of the study is to enhance active participation of bedside providers in RR by fostering self-determination through targeted education.Design: Needs assessment affirmed that bedside providers in our tertiary academic pediatric hospital felt loss of control over patient care, lack of competence, and disconnect from the RR team. We used the principles of autonomy, competence, and relatedness posited by the self-determination theory to guide the development, implementation, and evaluation of our educational program for bedside providers.Results: Forty-two bedside providers participated in our program. Participants reported significant improvement in RR-related clinical knowledge. More importantly, there was significant enhancement in individual perceptions of autonomy (pre-mean: 2.12, post-mean: 4.4) competence (pre-mean: 2.15, post-mean: 4.4), and relatedness (pre-mean: 2.65, post-mean: 4.5) with RR (p < 0.01). The evaluation results for overall educational effectiveness showed a mean score of 4.69 ± 0.79. All scores were based on a 5-point Likert scale of 1: poor to 5: excellent. Educators noted good participant engagement. The program’s structure, evaluations, and data management were modified based on the feedback.Conclusions: We successfully developed and implemented targeted educational program for bedside providers based on self-determination theory. The evaluations showed improvement in bedside providers’ clinical RR knowledge and perceptions of autonomy, competence, and relatedness following the training.
Highlights
The Institute of Healthcare Improvement as a part of the ‘Save 100,000 Lives Campaign’ recommended widespread implementation of rapid response (RR) systems or medical emergency teams to propagate patient safety and improve clinical outcomes [1,2]
We successfully developed and implemented targeted educational program for bedside providers based on self-determination theory
There was a significant increase in self-reported scores of self-determination theory (SDT) components: ability to maintain control over the RR situation, capacity to perform competently the tasks needed during RR, and feeling of inclusion in the team (Table 3)
Summary
The Institute of Healthcare Improvement as a part of the ‘Save 100,000 Lives Campaign’ recommended widespread implementation of rapid response (RR) systems or medical emergency teams to propagate patient safety and improve clinical outcomes [1,2]. The bedside providers (nurses and physicians) who are usually the initial responders (IRs) report certain unintended affective consequences of RR events. Whereas the IRs usually feel relieved when help arrives in the form of specialized responders (SRs), they perceive at times a criticism of their ongoing management that led to the need for RR and a burden to explain why the RR system was activated [11,12]. Widespread implementation of rapid response (RR) systems positively impacts outcomes of clinically unstable hospitalized patients. Objective: The objective of the study is to enhance active participation of bedside providers in RR by fostering self-determination through targeted education
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