None listed
Conditions
Interventions
None listed
Sponsors
Ajou University
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: a. Data analysis Adult patients (=18 years) who were admitted to the general wards at Ajou University Hospital for at least 24 hours between January 1, 2023, and December 31, 2024. The RRT activation group will include patients with at least one documented Rapid Response Team (RRT) activation or visit during the study period, whereas the non-activation group will include patients without any documented RRT activation or visit. A total of 100 cases for systematic chart review will be selected from the RRT activation group. b. Focus group interviews - Five RRT nurses with at least 5 years of clinical nursing experience, at least 1 year of RRT experience, and experience caring for patients requiring RRT intervention within the past year. - Five ward nurses with at least 5 years of clinical nursing experience, at least 1 year of experience in their current ward, and experience caring for patients requiring RRT intervention within the past year. - Participants who understand the purpose of the study and voluntarily provide informed consent. - Participants who are willing to share and discuss their experiences of caring for patients requiring RRT intervention.
Exclusion criteria
Exclusion criteria: a. Data analysis The following patients will be excluded from the data analysis: 1. Patients receiving end-of-life or palliative care, identified by palliative care or hospice-related diagnoses or admission to a palliative care unit during hospitalization. 2. Patients with documented Do-Not-Resuscitate (DNR) or Do-Not-Attempt-Resuscitation (DNAR) orders. However, patients whose DNR/DNAR orders were documented after RRT activation will not be excluded. 3. Patients who died within 24 hours of hospital admission. 4. Patients who were admitted exclusively to special care units, such as the intensive care unit, emergency department or operating room. 5. Patients with more than 30% missing data in key variables or whose records could not be reliably identified for analysis. b. Additional exclusion criteria - RRT activation group: Patients whose RRT visits were primarily for clinical support services (e.g., assistance with procedures, patient transport, or operation of medical equipment). - Non-RRT activation group: Patients who were directly transferred to the ICU or another higher level of care without RRT activation. c. Focus group interviews Participants will be excluded if they: - have less than one year of experience working as an RRT nurse or in their current ward. - decline or withdraw informed consent. - are administrative or non-clinical personnel not directly involved in patient care.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Predictive performance (AUROC, AUPRC, and calibration) of the in-hospital mortality prediction model (in-hospital death vs. survival to discharge), and the patterns and onset of early deterioration signals identified through time-indexed SHAP analysis | — |
Secondary
| Measure | Time frame |
|---|---|
| Differences in the frequency and patterns of nursing documentation across clinical domains between the RRT-activated and non-activated groups, comparison of SHAP signal patterns between the two groups, and exploration of the clinical context underlying RRT activation decisions through focus group interviews. | — |
Countries
Korea, Republic of
Contacts
Public ContactYOUNGJIN LEE
Ajou University
Outcome results
None listed