What Nurses Should Know About Rapid Response Teams

According to the Robert Wood Johnson Foundation, the increasingly common use of rapid response teams (RRTs) in hospitals is simultaneously saving patients’ lives and boosting the nursing profession. Too often, nurses have a gut feeling that something is not quite right with a patient, but unless the patient displays definitive signs of distress or goes into cardiac arrest, the nurse has little recourse. Rapid response teams can change that dynamic, by honoring those instincts and gut feelings and giving nurses a way to get help. In hospitals that have RRTs, any healthcare worker can bypass the typical chain of command and call for an intervention, without waiting for physician’s orders.

The RRT is a way to bring critical care and specialized medical expertise to the bedside quickly, without the need to transfer the patient to the ICU. It is based on the concept of “failure to rescue,” which refers to occasions in which clinicians don’t act on signs of deterioration in a patient’s condition soon enough to prevent death. Failure to rescue can be a result of planning failures (a patient receives inadequate treatment or assessment), a breakdown in communication between staff members, or a failure to recognize early or vague signs of deterioration in the patient.

In contrast to “code blue” teams, the RRT is designed to intervene before an adverse event—including cardiac arrest and septic shock—occurs. Team members can assemble quickly to assess and stabilize patients, usually in general medical/surgical units. Research shows that RRTs have an impressive track record of preventing unnecessary deaths.

Nurses may summon the RRT for physiologic changes in heart rate, blood pressure, oxygen saturation, respiration, urinary output. They can make the call when they see changes in mental state, such as confusion or delirium, or changes in lab values. Most importantly, they can call the RRT any time they feel a patient may be deteriorating, even in the absence of hard clinical data. This gives nurses the opportunity to save lives, by triggering an immediate evaluation by a team of experts. Yet in some studies, the bedside nurses surveyed said they sometimes felt uncomfortable stepping outside the normal chain of command, or worried that physicians would see them as defying authority or disagreeing with an established care plan. Hospitals can help to break down these chain-of-command barriers by promoting an overall culture of safety, fostering nurse-physician collaboration, and choosing RRT members carefully.

The composition of RRTs can vary from hospital to hospital, but may consist of a physician (hospitalist or intensivist), critical care nurse, respiratory therapist, resident or physician’s assistant, and some type of clinical nurse specialist. Team members must be available to respond immediately when called.

In its “5 Million Lives Campaign” between 2006 and 2008, the Institute for Healthcare Improvement (IHI) asked all U.S. hospitals to implement RRTs. As a result, RRTs have become an established standard of care. Do you want to make a similar impact on the lives of your patients? Empower yourself with knowledge through an online RN to BSN or RN to BSN/MSN degree. American Sentinel University is an innovative, accredited provider of online nursing degrees, including programs that prepare nurses for a specialty in nursing education, nursing informatics, and executive leadership