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Training of nurses and orderlies - factor in reducing mortality

Обучение среднего и младшего медперсонала – фактор снижения летальности

Training of nurses and orderlies - factor in reducing mortality

Background research: despite the fact that the outreach arrangements and early warning systems are an integral part of the organization of the patient unit, the widespread introduction of measures into practice is not based on solid scientific evidence.

Aim of the Cochrane study was to determine the effect of outreach services on mortality in intensive care. Cochrane study of treatment outcomes in common patient unit have shown that such patients are diagnosed with more signs of destabilization - changes in breathing and heart rate. These symptoms often are the precursors of life-threatening destabilization of vital functions. 

An important method of reducing mortality is training of junior and middle staff to proper assessment of vital parameters. Journal to record physiological parameters in each patient unit helps in this. A positive aspect is the creation of the teams responsible for responding to emergency situations within the hospital.

In the Cochrane review, two studies were conducted. One study compared the twelve hospitals, that conducted outreach sessions with staff, with eleven hospitals, that not conducted. We compared the patient units, also with and without outreach work (outreach - is the provision of information to the target groups in an informal conversation and confidential environment).

Three review authors independently have collected data, two authors assessed the methodological quality of the included studies. Meta-analysis was not performed due to the heterogeneity of the information. Summary statistics and descriptive summary of the primary and secondary outcomes were provided for each study.

The study included 23 Australian hospitals and 16 patient units in the UK. The primary outcome in the Australian segment did not show statistically significant differences. In the UK study found a decrease in mortality compared with the control group. The first study showed the benefits of outreach work with the staff, relatives and patients in reducing mortality, but the second did not reveal any differences. The findings had shown the need for more study.