1. Rapid Response Martin Bower Richelle Cisco Jerrica Crandall

2. What is a Rapid Response Team? A rapid response team (also known as RRT) consists of clinicians from various expertise, who provide emergency bedside care within minutes, to non-intensive care patients. They address clinical situations before they become life- threatening to patients.

3. Purpose of RRT ●Prevent patients from advancing into cardiac/respiratory arrest ●Increases overall survival rates ●Decreases admissions to ICU ●Prevent costly and unnecessary transfers to the ICU ●Fosters collaboration between medical-surgical nurses and ICU nurses in the care of the patient through: -assessment -support -communication -education -immediate interventions

4. Rapid Response is not a Code! If ACLS (Advanced Cardiac Life Support) interventions are required, such as intubation, cardioversion, or ACLS meds, an emergency cart must be called. This is a code!!!

5. When to Call RRT (Referring to Auburn Community Hospital’s Policy & Procedure) ●Concern or worry about pt condition ●Decreased LOC ●Alterations in consciousness ●Onset of agitation and delirium ●Seizures ●Change in respiratory status ●Change in HR ●Change in BP ●Unresolved CP ●Hemorrhage ●I/O or urine output below 50mL in 4 hours Note: Always refer to your institution’s P&P of when to call RRT

6. Members of RRT ●Pt’s primary nurse ●Critical Care Unit Nurse ●Respiratory therapist ●Nurse Manager/Supervisor ●Attending physician, hospitalist, Nurse Practitioner (when available) ●Members must be available to respond immediately-within 5 minutes of the call

7. Primary Nurse’s Role Initiates the Rapid Response Provides the pt’s history to the responders Reports changes in health status to the responders Provides care to the pt

8. Who Can Call RRT Anyone! ●Family ●Patient ●Nurse ●Secretary

9. Evidence-Based Practice “Underuse of RRT may negatively impact patient outcomes; conversely, as the number of RRT activations increase, patient outcome improve. Hospitals reporting 15 RRT activations per month per 1000 discharges show decreases in incidence of cardiopulmonary arrests, admissions to intensive care units, and overall mortality. Hospitals with less than 10 RRT activations per 1000 discharges do not demonstrate similar improvements.”

10. https://www.youtube.com/watch?v=twkAMnvS84M&feature=pla yer_detailpage

11. Code or Rapid Response Your patient stops breathing? Your patient has a sudden change in LOC? CPR has been started? Patient has uncontrolled bleeding/hemorrhage? Your patient just doesn’t “look” right?

12. List the criteria of when to activate Rapid Response

13. Resources Lewis, S. (2011). Medical-Surgical Nursing: Assessment and Management of Clinical Problems (8th ed., p. 1681-1682). St. Louis, MO.: Elsevier/Mosby. Grissinger, M. (2010). Rapid Response Teams in Hospitals Increase Patient Safety. Pharmacy and Therapeutics, 35($), 191-207. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873718/ Rapid Response Team Policy & Procedure. (2007, January 1). Retrieved March 29, 2015, from http://www.auburnhospital.org S Astroth, K., M Woith, W., Stapleton, S. J., Degitz, R. J., & Jenkins, S. H. (2013). Qualitative exploration of nurses' decisions to activate rapid response teams. Journal Of Clinical Nursing, 22(19/20), 2876-2882. doi:10.1111/jocn.12067