Ethical approval
The study protocol was reviewed and approved by the ethics committee of the Zhengzhou Central Hospital. The study population was derived from activated CROT patients in general wards.
Study design
Based on CCOT in the UK and RRT in the US,we established CROT.
The study was conducted from the May 2016 to the November 2019 in a 3122-bed Hospital in Zhengzhou of Henan Province.
The RRS comprises four key elements: an afferent limb (identification of patient deterioration by the ward staff and triggering of a response), the efferent limb (CROT), and the feedback and administrative components.In the study, the CROT serviced for the all inpatients. Firstly,daily patrol and early warning were conducted for the critically ill patients in the general ward. Patients with NEWS scoring≥7 score and consistent with the ICU admission were recommended to be transferred to ICU for further monitoring and treatment.Secondly, when acute adverse events occured in patients in non-critical departments, CROT was called for active rescue treatment. After completion of the intervention,the doctor was required to complete the SAE response sheet.
CROT activated criterias were: (1) respiratory system: respiratory frequency < 8 times /min or > 30 times /min, blood oxygen saturation (SpO 2) < 90% and oxygen intake ≥6L/min;(2) Nervous system: coma, sudden change of consciousness, seizure;(3) circulatory system: systolic blood pressure < 90mmHg or 20% lower than the basic value, heart rate > 140 times /min or < 40 times /min;(4) Kidney: Oliguria or absence of urine for more than one day.
Statistical methods
were performed using IBM SPSS version 25 (IBM Corp., Armonk, NY,USA). Descriptive statistics were generated and analyzed. we analyzed the age and gender distribution of patients, activation reasons, CROT arrival time, and patient outcomes.