[MikePerkins]

Some food for thought on advances in practice and in particular implimentation of rapid responce teams in our role as caregivers...

Lately I've been seeing an increase in the acuity of our patients over the past 3-4 years. I don’t know if it has to do with our medications increasing the life expectancies of our patients, doctors who are overburdened with patient loads missing important lab values on their checkups or just not following up appropriately, missed medications at home or improper dosing, or a combination of all of the above.

What’s happening more and more though is that hospitals are dealing with this by developing rapid response teams on the hospital floors, to assist us in assessing whether a patient is becoming acutely ill before they become a code blue situation.

I like the theory of it. It’s just the implementation, I feel, is lacking. Perhaps because its new and proper education hasnt been provided on how to utilize this new tool in assessment.

Personally I’ve always relied on my fellow staff and supervisors to assist me in the assessment of a patient who I have a gut feeling about. The times I have seen a rapid response team called, I felt it would of been more appropriate to of just called a code blue, as this gets all hands on deck. I have also noted that some of the people who came because of the rapid response team call were almost insulted that they were called for what they thought was trivial.

Honestly I also found the paper work after the rapid response team to be tedious and it just added another factor to my already busy day as well. But then again, I work at a small hospital that’s trying to take on a city hospital approach towards care of patients.

Anyway here is an interesting article I found on the internet discussing evolution of rapid response teams, its effect on the care of patients and how we can best utilize this tool.

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Any thoughts on this topic would greatly be appriciated, also interested in how you utilize rapid response teams in your care and examples of reasons why.

Cheers!
Mike

[NavyJim58]

MikePerkins, good questions and thoughts on the RRT. We have instituted the RRT at my hospital and so far it is of benefit. We have quite a few new nurses including new grads and some of those (as well as some older nurses) could be considered "weak". The RRT has really given our nurses a "boost" to their self esteem knowing they have this resource available if they get in a crises situation. Yes sometimes it turns out to be a minor problem but we try to use the RRT response calls as a learning situation. The key here is to have RRT members who like to teach and who have a good attitude toward the job. Also, yes there is always the job not done until the paperwork is finished.

[Ricu]

In my hospital, we've been using the rapid response team for over a year now and in general, have found it to be successful. Of course like others, we have have encountered issues around how to best utilize this resource but are committed to working at it. We continue to refine the process of implementation and documentation and have done serial inservices including mock calls. Ironically, it's been our experience that the most frequent obstacle to the team being called is the patients attending nurse. It seems ironically, as though calling for the rapid response team is viewed (by the nurse) as a failure on his/her part to be proactive in the patients treatment, like admitting to being unable to handle the situation. We all know that implementing this process is absolutely the most proactive decision that an attending nurse can make on behalf of the patient. It's better to steer into the wind and perhaps call prematurely rather than wait too long and risk causing the patient harm. In either case, the patient is assessed and treatment is reviewed and possible updated- a good thing. In practice, our findings have been that the nurses instinct is usually right on and almost always, the patients condition has deteriorated. Calling the team led to expediting care and gaining control over a condition before disaster ensues. Finally at the wrap up, we make sure to thank the nurse for calling and praise his/her quick action.

R

[gracie1]

We have implemented such a team in our corporation. We rarely use it on our floor (step down unit in a teaching facility) because the docs tend to take us seriously when we bug them about changes in the patients. But on the med surg floors and in the non-teaching facilities where docs are more likely to blow off the nurses, it has resulted in a decrease number of codes.