Date of Award

11-4-2024

Degree Type

Thesis

Degree Name

MSc in Nursing

First Advisor

Ms. Yasmin NadeemParpio

Second Advisor

Dr. Tazeen Saeed Ali

Third Advisor

Ms. Sumia Andleeb Abbasi

Department

School of Nursing and Midwifery, Pakistan

Abstract

Background: The transition of global health care with digital technologies has created a vast transformation that ensures patient safety, competence, and accessibility of standard care. In healthcare, nurses are always frontline warriors who significantly handle and deliver holistic care. A nurse should provide evidence-based care, and have sufficient knowledge and competencies regarding diagnosis, treatment, and prognosis. Lack of knowledge and critical thinking in the identification of patient warning signs leads to prolonging hospitalization and sometimes causes deterioration in health, leading to the end of life. The Rapid Response Team (RRT) has introduced which aims to recognize alarming signs in ill patients admitted to general units and special care units (SCU) at an early stage. RRT overcomes patient deterioration incidents, rush calls, or emergencies. An RRT specializes in handling crash conditions and doing efficient interventions to save the patient from danger. To reduce crash situations Modified Early Warning Score (MEWS) system was introduced which monitors key vital signs of patient's including heart rate, temperature, systolic blood pressure, respiratory rate, and using Glasgow coma scale (GCS) for assessing patient’s level of consciousness level. This approach helps to identify potentially life-threatening complications. This study aimed to access Knowledge and competencies of nurses working in adult inpatient settings in the initiation of rapid response team call at tertiary care hospital of Karachi, Pakistan.
Purpose: The study aimed to answer the following questions: 1. To assess the level of knowledge nurses working in adult inpatient settings in the initiation of rapid response team (RRT) call? 2. To assess the competencies nurses working in adult inpatient settings in initiating an RRT call?
Methods: An analytical cross-sectional study design was used to meet the study's objectives. A total of 203 nurses working in inpatient setting were recruited using consecutive sampling. Data was collected using a self-developed questionnaire of knowledge assessment tool modified early warning signs (MEWS) and RRT and competency assessment tool RRT and MEWS. Gender, age, years of experience, and credentials was taken as demographic variables. Data was analyzed through descriptive and inferential analysis in statistical package for social sciences (SPSS) version 22. Inferences were made using the chi-square test for the categorical variables, and T-test was used for two independent samples for continuous variables in the study.
Findings: The knowledge assessment tool RRT and MEWS reveals 56.7% (n=115) participants fell of in the criteria of inadequate knowledge regarding initiating RRT calls in inpatient settings. On the other hand, 43.3% (n=88) had the knowledge regarding generating RRT. Whereas, 52.2% (n=106) fell in the criteria of competent nurses working in an inpatient setting generating RRT. On the other hand, 47.8% (n=97) nurses were lacking incompetent in the initiation an RRT.
Conclusion: The findings indicate that nurses working in inpatient settings lack the necessary knowledge and competency to initiate RRT calls for patients displaying early warning signs and requiring prompt intervention based on their MEWS in order to prevent clinical deterioration. Markedly, gender and level of education did not exhibit a significant relation with the initiation of RRT calls; however, it was discerned that age and credentials served as crucial factors that enable nurses to engage in critical thinking in their professional roles.

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