2 nd A nnual N ursing R esearch & E vidence- B ased P ractice S ymposium Promoting Nursing’s Future: Building Bridges from Classrooms to Clinical Settings

Daniel Ampomah, RN, PhD, NE-BC Phillip Eaton, RN, MSN, RRT Rodica Sandor-Scoma, RN, MSHA, MD. Zewdensh Bryant, RN, BSN, MS.

In 2005 IMVH established a rapid response team to provide medical intervention at the first signs of a patient’s decline. Data suggests the RRT has decreased the mortality rate from 2.6% to 2.2% and increased the survival rate of this hospital. The hospital had no data that explored the attitudes of the nurses to the rapid response teams

The purpose of this study was to assess whether nurses valued the RRT service and to determine whether barriers to calling the RRT exist.

Do nurses understand the potential benefits of the rapid response team system? Do nurses find the rapid response team service useful in managing sick patients? Do obstacles exist that restrict nurses from using the rapid response team service?

 Research design: Univariate descriptive  Population: RNs and LPNs working on nursing units and departments in Inova Mount Vernon Hospital  Sample: Convenience sample

Newly hired and currently in orientation Employed and Working as an RN or LPN at IMVH Travelers, contract or agency per diem nurses working at IMVH

 Nurses Attitudes to Medical Emergency Teams Survey (NAMETS) by Jones, et al. (2006). Permission to use the NAMETS tool for this study was granted by Jones and Bellomo. For this study the tool was referred to as Nurses Attitudes to Rapid Response Team Survey(NARRTS)  Demographic data sheet  Reliability of NAMETS face validity  Reliability of NARRTS α =.60

 Paper survey  Descriptive statistics employing frequencies and percentages was used to answer the research questions.

A total of 140 of the surveys were returned. At the time of the survey 266 nurses were employed at the hospital 196 questionnaires were distributed to nurses on day, evening and night shifts 74% of the accessible target population were surveyed Overall response rate was 71% a b c d e

Age of respondents GenderRace/EthnicityEmployment status Yrs nursing practice Years worked at IMVH Youngest respondent was 24 years old Male 13 (9%) African- American/Black 63 (46%) Full time 91 (66%) 1-5 yrs 24% 1-5yrs 85 (62%) Oldest respondent was 65 years old Female 126 (91%) Asian/Pacific Islander 18 (13%) Part time 21 (15%) 6-10yrs 21% 6-10 yrs 38 (28%) Mean age of the sample was 43 yrs Caucasian/White 47 (34%) PRN 27 (19%) 11-15yrs 16% Over 10yrs 14 (10%) Hispanic/ Latino 2 (1%) 16-20yrs 18% Other 8 (6%) 21-30yrs 15% yrs 7% Sample Matrix

Level of education Work shiftSpecialty of practice Have you ever called the RRT to manage a patient in your care? Diploma 10 (7%) Day shift 71 (52%) Psychiatry 15 (11%) Yes = 112 (84%) Associate Degree 59 (42%) Night shift 65 (47%) Oncology 12 (9%) No = 22 (16%) Baccalaureate Degree 62 (45%) Orthopedics 17 (13%) Masters in nursing 6 (4%) Medical/surgical 31 (23%) Other 7 (1%) Telemetry 27 (20%) Rehabilitation 32 (24%) Sample Matrix

MAJOR FINDINGS

In all, 96% of the respondents agreed or strongly agreed that patients in the hospital have complex medical problems.

95% of the nurses agreed or strongly agreed that RRT prevents unwell patients from having an arrest. 90% of the nurses agreed or strongly agreed that the RRT can be used to prevent a minor problem from becoming a major problem.

96% of the nurses agreed or strongly agreed that RRT allowed them to seek help in managing a patient they are worried about 89% of the nurses disagreed or strongly disagreed when asked if they thought that the RRT is not helpful in managing sick patients. 72% disagreed or strongly disagreed when asked if they thought that the RRT was overused in the management of hospital patients.

When asked if they were reluctant to make a RRT call on a patient for fear of criticism if the pt was not that unwell, 82% disagreed or strongly disagreed, only 13% agreed. 94% of the nurses strongly disagreed or disagreed when questioned whether they do not like making RRT calls because they will be criticized for not looking after their patients well. 86% disagreed or strongly disagreed that using the RRT system increases their workload when caring for sick patients.

52% of the nurses agreed or strongly agreed that they would call the house doctor before the RRT when one of their pt was sick. 28% disagreed and 20% were unsure. 67% strongly agreed or agreed that they would call the RRT if they could not contact the house doctor about a sick patients.

74% agreed or strongly agreed that they would make a RRT call on a pt they were worried about even if their vital signs were normal. When asked if they would not make a RRT call on a pt who fulfilled the RRT criteria but did not look unwell, 81% strongly disagreed or disagreed,13% were unsure, and 6% agreed.

Almost 96% of the nurses disagreed or strongly disagreed about whether they thought the RRT reduced their skills in managing sick patients. 68% agreed or strongly agreed that the RRT teaches them how to better manage sick patients in their care.

The researchers found that: Most respondents indicated that they value the RRT service. RRT was useful in the management of hospital pts RRT was not overused in the management of hospital pts Nurses in this hospital value the use of clinical judge in decision making. Regardless, 52% of the nurses still said they would call the house doctor before calling RRT for a sick pt.

Thank You

Questions?