Publication Date

Spring 5-1-2015

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Diane Stuenkle, Chair

Second Advisor

Elizabeth (Pepe) Greenlee

Third Advisor

Debrayh Gaylle

Keywords

Rapid response team, RRT Medical-Surgical Nursing

Abstract

Rapid Response Team Intervention (RRTI) is a widely used intervention in acute care hospitals in the United States. Demonstrated effectiveness in preventing transfer to higher level of care or in decreasing in-hospital mortality has not been established. This exploratory study used a retrospective chat1 review to examine differences between medical-surgical acute care inpatients who had an RRTI and a control group. CutTent literature lacks information on proactive detection of patients who may be more likely to deteriorate and therefore require a Rapid Response Team Intervention. Therefore, this study's PICO question was: Are there statistically significant differences between medical-surgical adult inpatients who required Rapid Response Team Intervention and those who did not for demographic characteristics and selected clinical parameters (vital signs, level of consciousness, etc.)? The chat1s of all RRT patients on three medical-surgical units in a community hospital for a period of one year were reviewed (n=135) with an accompanying chart review ofthree control patients for every RRT patient (n = 331 ). Variables included a descriptive set, the study hospital's policy of"cdteria for calling an RRT" and other independent predictor variables. Results yielded five statistically significant differences between RRT and control 3 patients: age, history of psychiatric/mental illness, use of respiratory medications such as inhalers and steroids and use of medications to treat psychiatric/mental illness. There was a large variation in response time to "criteria for calling an RR T". Abnormal vital signs were documented in the electronic medical record (EMR) but at times it was hours before the RRT was summoned. This variation in the reaction of the primary nurses caring for the deteriorating patient suggests automation of calling an RRT could improve patient care by reducing delays. There also is a need to increase awareness of the vulnerabi lity of psychiatric/mentally ill patients and chronic cardiac disease patients, and their greater likelihood of needing RRTI during hospitalization.

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