Abstract
Modeled after the Rapid Response Team concept, our Early Nursing Intervention Team (ENIT) was created to avert patient emergencies by providing critical care outreach before a patient’s condition deteriorates to the point of cardiopulmonary arrest.  There has been a worldwide effort towards this goal led by experts in Australia and the United Kingdom.  The literature is replete with evidence suggesting that adverse patient events could have been avoided had clinical deterioration been recognized earlier and treated more promptly. Several studies have reported the benefit of an early intervention process and have described a reduction in arrest scenarios outside intensive care units (ICUs) and an improvement in survival to discharge.
A collaborative effort between medical staff, nursing administration, clinical leadership, and staff nurses led to the development of a nurse-led team inspired by the Institute for Healthcare Improvement’s 100,000 lives campaign.   The ENIT nurse is the critical-care charge nurse, free of a patient assignment, which enables him/her to round twice daily throughout the hospital and to respond to calls in the event of patient decline.  Data was collected both retrospectively and prospectively to assess the effectiveness of the program.  Patient outcomes examined include length of time between identification of patient deterioration and transfer to ICU, cardiac arrest events, and length of stay.
The most compelling result was that time to transfer patients to ICU decreased from a mean of 242.12 minutes before the ENIT program to 88.65 minutes during the study period.  Cardiac arrest events outside ICU dropped from 45 events in the 12 months preceding ENIT to just 25 in the same time period after introduction of the program.  Length of stay increased from a mean of 5.25 days to 7.43 days.  Clearly, ENIT has resulted in increased support of the general care nurse and improved patient outcomes.