The CCO-RE study

  • Research type

    Research Study

  • Full title

    Characterising the work of Critical Care Outreach Nurses using Resilience Engineering - The CCO-RE study.



  • Contact name

    Amy Silver

  • Contact email

  • Sponsor organisation

    City, University of London

  • Duration of Study in the UK

    0 years, 10 months, 30 days

  • Research summary

    There is a nationwide effort to improve how hospitals identify, respond to, and care for patients who become critically ill during their hospital admission. Rapid Response Systems (RRSs) are present in many hospitals across the UK. The purpose of the RRS is to help clinical staff to recognise patients who are deteriorating, and activate a time-critical response from the right person or team. In the UK, this response is the remit of Critical Care Outreach (CCO) nurses.

    CCO nurses are clinical experts with specialised knowledge in detecting, managing, and caring for critically ill patients. It is broadly acknowledged that CCO nurses provide a valuable service. However it has been difficult to evidence how CCO nurses help keep patients safe in hospitals. This may be due to variation between teams and hospitals, a lack of randomised controlled trials, and a historical focus on measuring quantitative outcomes like illness and death rates.

    The study proposes to use a theoretical resilience engineering model to as a lens to understand and analyse the activities and behaviours of CCO nurses, and examine how CCO nurses uphold and maintain the response arm of the RRS.

    Participants in the study will be CCO nurses working in a large NHS hospital in the UK. The researcher will spend eight weeks observing and interviewing the nurses to understand how they respond to clinical needs, anticipate challenges, and adjust their approach during periods of high activity to continue to meet the needs of unwell patients.

    Funding for the study is provided by a personal award, through the National Institute of Health Research (NIHR) Pre-Doctoral Academic Fellowship program.

  • REC name

    East of Scotland Research Ethics Service REC 2

  • REC reference


  • Date of REC Opinion

    4 Aug 2023

  • REC opinion

    Favourable Opinion