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Research Article: Impact of Rapid Response Teams on Pediatric Care: An Interrupted Time Series Analysis of Unplanned PICU Admissions and Cardiac Arrests

Date Published: 2024-02-21

Abstract:
Pediatric rapid response teams (RRTs) are expected to significantly lower pediatric mortality in healthcare settings. This study evaluates RRTs’ effectiveness in decreasing cardiac arrests and unexpected Pediatric Intensive Care Unit (PICU) admissions. A quasi-experimental study (2014–2017) at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, involved 3261 pediatric inpatients, split into pre-intervention (1604) and post-intervention (1657) groups. Baseline pediatric warning scores and monthly data on admissions, transfers, arrests, and mortality were analyzed pre- and post-intervention. Statistical methods including bootstrapping, segmented regression, and a Zero-Inflation Poisson model were employed to ensure a comprehensive evaluation of the intervention’s impact. RRT was activated 471 times, primarily for respiratory distress (29.30%), sepsis (22.30%), clinical anxiety (13.80%), and hematological abnormalities (6.7%). Family concerns triggered 0.1% of activations. Post-RRT implementation, unplanned PICU admissions significantly reduced (RR = 0.552, 95% CI 0.485–0.628, p < 0.0001), and non-ICU cardiac arrests were eliminated (RR = 0). Patient care improvement was notable, with a ?9.61 coefficient for PICU admissions (95% CI: ?12.65 to ?6.57, p < 0.001) and a ?1.641 coefficient for non-ICU cardiac arrests (95% CI: ?2.22 to ?1.06, p < 0.001). Sensitivity analysis showed mixed results for PICU admissions, while zero-inflation Poisson analysis confirmed a reduction in non-ICU arrests. The deployment of pediatric RRTs is associated with fewer unexpected PICU admissions and non-ICU cardiopulmonary arrests, indicating improved PICU management. Further research using robust scientific methods is necessary to conclusively determine RRTs’ clinical benefits.

Introduction:
Indeed, due to recent advancements in pediatric care and medical technology, the proportion of children who now survive once-fatal disorders that were once deadly has grown dramatically, changing the epidemiology of pediatric [1,2] ailments that affect between 0.4% and 0.7% of all children and account for 42% of pediatric inpatients and up to 53% of PICU admissions at any given time [3]. Similar situations can be found in wealthier countries [4]. As a result, hospitalized pediatric patients frequently experience…

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