Other Titles

Rising Star Poster/Presentation - Rapid Presentation Round

Abstract

Background/Significance of problem: Rapid Response Teams have been used to reduce the incidence of intrahospital decline. While these teams excel at providing emergent responses during times of critical illness, they generally lack a proactive approach.

Clinical question/project purpose: Is a dedicated Rapid Response Nurse role effective in improving the culture of safety and reducing Rapid Response Team activations? The purpose of this project is to implement a dedicated Rapid Response Nurse (RRN) role that aids nurses in identifying patients at risk of decline or who are currently declining.

Search of literature/best evidence: A literature search was completed for full-text, English-language studies on Rapid Response Teams (RRT) and Rapid Response Nurses (RRN). CINAHL, Medline, PubMed, and Cochrane Library were searched for original research studies using the keywords “Rapid Response Team”, “Rapid Response System”, “Rapid Response Nurse”, “failure to rescue”, and “proactive”. Studies dated prior to 2016 were excluded except for cases of seminal work. The search produced descriptive, quasi-experimental, mixed-method, and qualitative studies.

Clinical appraisal of literature/best evidence: Analysis of the evidence suggests four findings: 1) RRT studies focus on decreasing cardiac arrests and intubations outside of the ICU setting; 2) RRT benefits vary due to the heterogeneity of team structures; 3) few organizations utilize a proactive approach in their Rapid Response structure; and 4) there are limited studies that focus on a Registered Nurse in a proactive RRN role.

Integration into practice: This project includes five inpatient units at a suburban hospital. RRNs will be hired from the existing ICU roster with the goal that all shifts will be staffed. RRNs will proactively round on all five units and can be consulted by any staff member; consult does not require a physician order.

Evaluation of evidence-based practice: The project will include a pre- and post-comparative survey design which includes the AHRQ SOPS survey and will be conducted prior to project implementation and three-and six months post. Concurrently, the number of RRT activations and RRN consults will be evaluated.

Notes

Presenter notes available in slide deck.

References:
Agency for Healthcare Research and Quality. (2022). Hospital survey on patient safety culture. https://www.ahrq.gov/sops/surveys/hospital/index.html

Agency for Healthcare Research and Quality. (2022). What is patient safety culture? https://www.ahrq.gov/sops/about/patient-safety-culture.html

Benin, A. L., Borgstrom, C. P., Jenq, G. Y., Roumanis, S. A., & Horwitz, L. I. (2012). Defining impact of a rapid response team: qualitative study with nurses, physicians and hospital administrators. BMJ Quality & Safety, 21(5), 391–398. https://doi.org/10.1136/bmjqs-2011-000390

Chua, W. L., See, M. T. A., Legio-Quigley, H., Jones, D., Tee, A., & Liaw, S. Y. (2017). Factors influencing the activation of the rapid response system for clinically deteriorating patients by frontline ward clinicians: a systematic review. International journal for quality in health care: journal of the International Society for Quality in Health Care, 29(8), 981–998. https://doi.org/10.1093/intqhc/mzx149

Dukes, K., Bunch, J. L., Chan, P. S., Guetterman, T. C., Lehrich, J. L., Trumpower, B., Harrod, M., Krein, S. L., Kellenberg, J. E., Reisinger, H. S., Kronick, S. L., Iwashyna, T. J., Nallamothu, B. K., & Girotra, S. (2019). Assessment of rapid response teams at top-performing hospitals for in-hospital cardiac arrest. JAMA Internal Medicine, 179(10), 1398–1405. https://doi.org/10.1001/jamainternmed.2019.2420

Heal, M., Silvest-Guerrero, S., & Kohtz, C. (2017). Design and development of a proactive rapid response system. Computers, Informatics, Nursing: CIN, 35(2), 77–83. https://doi.org/10.1097/CIN.0000000000000292

Milliken, C.L., Goodwin-Esola, M., & Seeley, S. (2018). Implementation of a pre-rapid response nurse: A success story. Nurse Leader, 16(5), 326-330. https://doi.org/10.1016/j.mnl.2018.06.003

Olsen, S. L., Søreide, E., Hillman, K., & Hansen, B. S. (2019). Succeeding with rapid response systems - a never-ending process: A systematic review of how health-care professionals perceive facilitators and barriers within the limbs of the RRS. Resuscitation, 144, 75–90. https://doi.org/10.1016/j.resuscitation.2019.08.034

Description

Is a dedicated Rapid Response Nurse role effective in improving the culture of safety and reducing Rapid Response Team activations? The purpose of this project is to implement a dedicated Rapid Response Nurse (RRN) role that aids nurses in identifying patients at risk of decline or who are currently declining.

Author Details

Brandie Kopsas-Kingsley BSN, RN, CCRN, DNP Student - University of Southern Indiana College of Nursing & Health Professionals

Sigma Membership

Omicron Psi

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Rapid Response Team, Adverse Health Care Event, Nursing Role, Rapid Response Nurse

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Washington, DC, USA

Conference Year

2024

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-02-16

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Implementation of a Dedicated Rapid Response Nurse

Washington, DC, USA

Background/Significance of problem: Rapid Response Teams have been used to reduce the incidence of intrahospital decline. While these teams excel at providing emergent responses during times of critical illness, they generally lack a proactive approach.

Clinical question/project purpose: Is a dedicated Rapid Response Nurse role effective in improving the culture of safety and reducing Rapid Response Team activations? The purpose of this project is to implement a dedicated Rapid Response Nurse (RRN) role that aids nurses in identifying patients at risk of decline or who are currently declining.

Search of literature/best evidence: A literature search was completed for full-text, English-language studies on Rapid Response Teams (RRT) and Rapid Response Nurses (RRN). CINAHL, Medline, PubMed, and Cochrane Library were searched for original research studies using the keywords “Rapid Response Team”, “Rapid Response System”, “Rapid Response Nurse”, “failure to rescue”, and “proactive”. Studies dated prior to 2016 were excluded except for cases of seminal work. The search produced descriptive, quasi-experimental, mixed-method, and qualitative studies.

Clinical appraisal of literature/best evidence: Analysis of the evidence suggests four findings: 1) RRT studies focus on decreasing cardiac arrests and intubations outside of the ICU setting; 2) RRT benefits vary due to the heterogeneity of team structures; 3) few organizations utilize a proactive approach in their Rapid Response structure; and 4) there are limited studies that focus on a Registered Nurse in a proactive RRN role.

Integration into practice: This project includes five inpatient units at a suburban hospital. RRNs will be hired from the existing ICU roster with the goal that all shifts will be staffed. RRNs will proactively round on all five units and can be consulted by any staff member; consult does not require a physician order.

Evaluation of evidence-based practice: The project will include a pre- and post-comparative survey design which includes the AHRQ SOPS survey and will be conducted prior to project implementation and three-and six months post. Concurrently, the number of RRT activations and RRN consults will be evaluated.