快速反应系统对住院患者临床结局影响的系统评价再评价

The effect of Rapid Response Systems on the clinical outcome of inpatients: an overview of systematic review

目的:将快速反应系统(RRS)对住院患者临床结局影响的系统评价进行再评价。方法:计算机检索The Cochrane Library、PubMed、Medline、CINAHL、EMBASE、CNKI、CMB、WANFANG和VIP数据库,收集RRS的应用对住院患者临床结局影响的系统评价或Meta分析。2位研究者分别独立进行文献筛选、资料提取,采用AMSTAR量表对纳入研究进行方法学质量评价。结果:共纳入14篇系统评价。AMSTAR评价结果显示,仅4篇为高质量,报告最差的条目为“是否提供了纳入和排除的研究文献清单”(12篇),“发表状态是否已考虑在纳入标准中”(11篇)和“是否提供了前期设计方案”(11篇),其次是“是否说明相关的利益冲突”(10篇)。结论:目前RRS对住院患者临床结局影响的系统评价的方法学质量总体不高。RRS对住院患者临床结局起积极作用,但临床全面推荐开展RRS来优化不良事件管理尚须进一步探讨和验证,同时也提示护理人员须全面提升自身专业水平,以适应RRS的要求。

Objective:To reevaluation the systematic review of the impact of all Rapid Response Systems(RRS)on clinical outcomes in inpatients.Method:The Cochrane Library,PubMed,Medline,CINAHL,EMBASE,CNKI,CMB,WANFANG and VIP database were searched for systematic review or Meta analysis of the impact of all RRS on clinical outcomes in inpatients.Two authors independently screened literature,extracted data and assessed the quality of included studies using the AMSTAR scale.Results:A total of 14 systematic reviews were included.The AMSTAR evaluation results showed that only 4 articles were of high quality,and the worst items in the report were"whether a list of included and excluded research literature was provided"(12 articles),and"whether publishing status was considered in including criteria"(11 articles),whether a preliminary design scheme was provided"(11 articles),followed by"whether the relevant conflicts of interest were explained"(10 articles).Conclusion:The quality of methodology in systematic review is generally poor.The RRS plays a positive role in the prognosis of in patients,while it still needs further discussion and verification to recommend in clinical to optimize the management of adverse events.It also indicates nurses should improve their professional level to meet the needs of RRS.