Impact of patient monitoring on the diurnal pattern of medical emergency team activation

Critical Care Medicine
Sanjay Galhotramembers of the Medical Emergency Response Improvement Team (MERIT) Committee

Abstract

To study the impact of time of day, day of week and level of patient monitoring on medical emergency team (MET) activation. Retrospective observational study of all MET and cardiac arrest events between October 2001 and March 2005. University of Pittsburgh Medical Center Presbyterian Hospital, a tertiary care teaching facility in the United States. None. Cardiac arrest and MET event rate during the day (7 am to 6:59 pm) and night (7 pm to 6:59 am) overall; for weekdays and weekends; and from unmonitored, monitored, and intensive care units (ICUs). There were 605 cardiac arrest and 4,072 MET events. MET event rate was higher during the day than at night in unmonitored units (62% day vs. 38% night; p<.001) and monitored units (59% day vs. 41% night; p<.001) but not in ICUs (47% day vs. 53% night; p=.20). Unmonitored units had a greater daytime increase in MET event rate than monitored units (63% vs. 46%), whereas ICUs showed an 11% decline compared with night. The MET day vs. night difference was greater on weekdays (65% day vs. 35% night; p<.001) than on weekends (56% day vs. 44% night; p<.001). Cardiac arrest event rate showed no diurnal pattern in any unit setting but had a higher daytime event rate during weekdays (57% day vs...Continue Reading

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