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American Journal of Critical Care. 2010;19: 74-83 doi:10.4037/ajcc2009532
Copyright © 2010 by the American Association of Critical-Care Nurses.
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A Survey of Nurses’ Beliefs About the Medical Emergency Team System in a Canadian Tertiary Hospital

By Sean M. Bagshaw, MD, MSc, Eugene E. Mondor, RN, Cindy Scouten, RN, Carmel Montgomery, RN, Linda Slater-MacLean, RN, Daryl A. Jones, MD, Rinaldo Bellomo, MD, R. T. Noel Gibney, MD for the Capital Health Medical Emergency Team Investigators. Sean M. Bagshaw, Eugene E. Mondor, Cindy Scouten, Linda Slater-MacLean, and R. T. Noel Gibney all work in the Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. Carmel Montgomery works for Regional Quality, Capital Health Region, in Edmonton. Daryl A. Jones is a research fellow at the Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. Rinaldo Bellomo is a physician in the Department of Intensive Care, Austin Hospital in Melbourne.

Corresponding author: Sean M. Bagshaw, MD, Division of Critical Care Medicine, University of Alberta Hospital, 3C1.16 Walter C. Mackenzie Centre, 8440 112th Street, Edmonton, Alberta T6G 2B7, Canada (e-mail: bagshaw{at}ualberta.ca).

Background Nurses are the primary activators of the medical emergency team (MET). Although the MET system can empower nurses to seek help in managing acutely ill patients, few data on nurses’ beliefs about the system are available.

Objective To evaluate nurses’ beliefs and behaviors about the MET system.

Methods Nurses from a large academic hospital in Canada were surveyed (2 demography-related questions and 17 Likert-scale questions).

Results Of 614 nurses employed on units participating in the MET system, 293 (47.7%) were approached and 275 completed the survey (response rate, 93.9%). Most respondents (84.2%) believed that the MET could prevent cardiopulmonary arrest in acutely ill patients, and 94% believed that the MET allowed them to seek help for patients they were worried about. Most nurses (75.9%) would call the responsible physician before activating the MET. Fifteen percent indicated reluctance to activate the MET because of fear of criticism, but only 2.2% considered the MET overused. Most (81.3%) believed that the MET did not increase their workload, and 91.3% did not believe that the MET reduced their skills. Forty-eight percent of nurses indicated that they would activate the MET for a patient they were worried about, even if the patient had normal vital signs.

Conclusion Nurses value the MET system. Nurses believe that the MET can help them care for acutely ill patients and improve outcomes. However, barriers to MET activation exist, including a fear of criticism and an adherence to a more traditional model of first contacting the responsible physician before activating the MET.


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