LAUSR

Background Information Failure to rescue accounts for approximately 60,000 deaths each year in Medicare patients under the age of 75. In a large outpatient oncology facility that encompasses an infusion center, multimodality procedure unit, radiation treatment center & multidisciplinary clinic, the need to implement a rapid rescue team was identified to mitigate the risk of failure to rescue. Objectives of Project The goal of this initiative was to implement a Medical Emergency and Rapid Intervention Team (MERIT) service to care for patients undergoing chemotherapy, blood transfusions, procedures, radiation and other oncology treatments. A standardized process was developed for MERIT activation by healthcare providers within the facility. In-Service all employees in the facility and empower them to activate MERIT for identified patients. Process of Implementation The current MERIT policy for inpatients was reviewed and collaboration was formed with institutional leaders to revise it for an ambulatory center. A needs assessment was conducted and knowledge deficits were identified. The skill mix of PACU nurses was reviewed to identify those with a high acuity background to be a core member of the MERIT team. An orientation and competency check-off was developed, which included requiring members to have Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS) and High Acuity Training. A post-implementation survey was conducted to assess needs and knowledge gaps. Statement of Successful Practice The assessment survey indicated 83% of staff were able to identify all the correct situations to call MERIT, 9% of staff were not sure what situations require MERIT and 25% of staff did not know the correct extension to request MERIT. Post implementation of MERIT service, the building team members indicated 84.4% of the staff were able to identify correct situations to call MERIT, and 98% of the staff knew the correct extension to request MERIT. Post education survey was done 2 weeks after go live and showed improvement in knowledge and comfort level in calling MERIT. Implications for Advancing the Practice of Perianesthesia Nursing Providing a MERIT service in an outpatient facility could mitigate the risk of failure to rescue, and improve patient outcomes.