Overcoming Barriers Impeding Nurse Activation of Rapid Response Teams

Management of rapid patient deterioration requires prompt recognition and swift response by bedside nurses and specially trained personnel, who successfully intervene to improve patient outcomes. Timely recognition and activation of rapid response mechanisms requires prudent nursing care. When patient needs and nurse competencies are unbalanced, patient outcomes decline and nurse confidence diminishes. This article offers a brief background of rapid response, including the supporting theoretical framework. Also discussed are barriers to nursing action that result in synergistic imbalance, including: bedside nurse competence to recognize patient deterioration and activate rapid response systems; bedside nurse clinical judgment, interdisciplinary teamwork; and organizational culture. The article includes implications for practice aims to address identified barriers and improve patient outcomes.

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Proceedings of the 12th International Conference on Rapid Response Systems and Medical Emergency Teams

Anaesthesia and Intensive Care ◽

10.1177/0310057x1704500416 ◽

2017 ◽

Vol 45 (4) ◽

pp. 511-517 ◽

Cited By ~ 3

Author(s):

D. Jones ◽

J. Holmes ◽

J. Currey ◽

E. Fugaccia ◽

A. J. Psirides ◽

...

Keyword(s):

Care Setting ◽

Rapid Response ◽

Medical Emergency ◽

Acute Care Setting ◽

Rapid Response Teams ◽

International Conference ◽

Rapid Response Systems ◽

Hospitalised Patients ◽

Medical Emergency Teams ◽

Response Systems

Rapid Response Teams (RRTs) have been introduced into hospitals worldwide in an effort to improve the outcomes of deteriorating hospitalised patients. Recently, there has been increased awareness of the need to develop systems other than RRTs for deteriorating patients. In May 2016, the 12th International Conference on Rapid Response Systems and Medical Emergency Teams was held in Melbourne. This represented a collaboration between the newly constituted International Society for Rapid Response Systems (iSRRS) and the Australian and New Zealand Intensive Care Society. The conference program included broad ranging presentations related to general clinical deterioration in the acute care setting, as well as deterioration in the emergency department, during pregnancy, in the paediatric setting, and deterioration in mental health status. This article briefly summarises the key features of the conference, links to presentations, and the 18 abstracts of the accepted free papers.

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Paediatric cardiac rapid response systems: a survey of multicentre practices

Cardiology in the Young ◽

10.1017/s1047951121003322 ◽

2021 ◽

pp. 1-8

Author(s):

Aarti C. Bavare ◽

Natasha S. Afonso ◽

Kerry A. Sembera ◽

Jason R. Buckley ◽

Tia T. Raymond ◽

...

Keyword(s):

United States ◽

United States Of America ◽

The United States ◽

Rapid Response ◽

Cardiac Patients ◽

Limited Information ◽

Rapid Response Teams ◽

Rapid Response Systems ◽

Outcomes Evaluation ◽

Response Systems

Abstract Introduction: While the efficacy and guidelines for implementation of rapid response systems are well established, limited information exists about rapid response paradigms for paediatric cardiac patients despite their unique pathophysiology. Methods: With endorsement from the Paediatric Cardiac Intensive Care Society, we designed and implemented a web-based survey of paediatric cardiac and multidisciplinary ICU medical directors in the United States of America and Canada to better understand paediatric cardiac rapid response practices. Results: Sixty-five (52%) of 125 centres responded. Seventy-one per cent of centres had ∼300 non-ICU beds and 71% had dedicated cardiac ICUs. To respond to cardiac patients, dedicated cardiac rapid response teams were utilised in 29% of all centres (39% and 5% in centres with and without dedicated cardiac ICUs, respectively) [p = 0.006]. Early warning scores were utilised in 62% of centres. Only 31% reported that rapid response teams received specialised training. Transfers to ICU were higher for cardiac (73%) compared to generalised rapid response events (54%). The monitoring and reassessment of patients not transferred to ICU after the rapid response was variable. Cardiac and respiratory arrests outside the ICU were infrequent. Only 29% of centres formally appraise critical deterioration events (need for ventilation and/or inotropes post-rapid response) and 34% perform post-event debriefs. Conclusion: Paediatric cardiac rapid response practices are variable and dedicated paediatric cardiac rapid response systems are infrequent in the United States of America and Canada. Opportunity exists to delineate best practices for paediatric cardiac rapid response and standardise practices for activation, training, patient monitoring post-rapid response events, and outcomes evaluation.

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