Date of Award

1-2023

Document Type

Thesis

College

School of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Carol Rossman

Second Advisor

Maureen Bishop

Abstract

Background

Rapid Response Teams (RRT) provide clinical resources to improve patient safety outcomes at healthcare institutions. This team promptly responds to deteriorating patient conditions to prevent further deterioration and reduce mortality rates. Rapid response teams do not always perform optimally. Reasons for this performance failure include breakdowns in communication, team dynamics, or other variables that can often be adjusted when the team members understand the role these variables play in undermining the performance of the RRT. An understanding of the perceptions of the RRT members regarding their roles and potential areas of improvement did provide valuable data that was utilized to improve the efficiency and effectiveness of the RRT.

Purpose

The purpose of this project was to create an evidence-based protocol for best practices in RRT responses by evaluating the perceptions of the rapid response team members regarding RRT performance at a medical center in Michigan. Current RRT practices were compared to the evidence-based standards of care that influenced recommendations for improvement based on the gaps identified. -- Method. This project utilized a qualitative approach with the use of semi-structured guided interviews held via Zoom to gather data related to the experiences of RRT members, to gain an in-depth understanding on the issues concerning the performances of the RRT. Seventeen participants who met the research criteria were selected. Participants who consented to be interviewed were scheduled in chronological order in which they gave consent. Participants were recruited via hospital unit huddles and one on one encounters, based on the project inclusion criteria, and were then scheduled for individual interviews that were audio-recorded, transcribed, and analyzed for thematic contents. This project was guided by Kurt Lewin's Change Theory, which is a change model geared at preparing team members to become change agents. Applying this model will ensure that team members will be equipped to implement the quality improvement changes in the rapid response system. Associates will be provided with the necessary strategies to unlearn the ineffective old ways of clinical practices and embrace the new evidenced based practice guidelines.

Results

Data analysis revealed major themes that have been affecting the performances of the RRT. They were ineffective team dynamics, activation barriers, inadequate competency training/skills validation, staffing challenges, and failure to debrief after RRT encounters. Other issues emerged during this study that were important issues affecting the performances of the RRT. They were delayed response time of RT, attitudes of providers, and unavailability of attending physicians.

Conclusion

Ineffective team dynamics, poorly defined roles, crowd control issues, and inadequate education and training were the most critical factors interfering with the efficiency of the RRT. A change in policy that has the potential to optimize the performance of the RRT was developed in accordance with the best practice guidelines. The rapid response team is an important player in early recognition of declining patient conditions outside of intensive care areas. There is documented evidence of what excellent rapid response teams need to maintain their efficient performance. Teams may not always function at the optimum levels they desire. The qualitative interview results derived from experienced rapid response team members was compared with evidence based standards of practice. Improvements and recommendations were developed and shared with the management team at the project site.

Subject Area

Nursing; Rapid Response Teams

DOI

https://dx.doi.org/10.32597/dnp/14/

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