Factors Influencing Registered Nurses' Decision to Activate an Adult Rapid Response Team in a Community Hospital. 2016

Shirley Jackson, and Barbara Penprase, and Claudia Grobbel
Shirley Jackson, DNP, RN, CCRN, CCNS, is a clinical nurse specialist at Elliot Health System, Manchester, NH. Her clinical specialty is adult acute and critical care nursing. Barbara Penprase, PhD, RN, CNE, ANEF, is a professor at the School of Nursing, Oakland University Rochester; and endowed professor, Oakland University School of Nursing/Crittenton Hospital Medical Center, MI. Her research interests include alarm fatigue, empathy vs systemizing traits in nurses and frequent users of the Emergency Department. Claudia Grobbel, DNP, RN, is an assistant professor at Oakland University, Rochester, MI. Her expertise is in the area of cardiac care, leadership and administration. Her research interest is caring practice and the impact on quality care.

BACKGROUND One factor impacting patient outcomes in the acutely deteriorating patient is a delay by nursing staff to activate a rapid response team (RRT); however, a gap in knowledge exists concerning factors influencing activation of an RRT by nursing staff working in adult areas outside the medical-surgical and telemetry setting. OBJECTIVE The purpose of this study was to examine beliefs and behaviors that influence registered nurses' decision to activate an adult rapid response team in a community hospital that includes 3 specialties: medical-surgical and telemetry, peripartum, and psychiatric areas. METHODS One hundred sixty-three nurses were surveyed using a 17-item Likert-style instrument to assess registered nurses' beliefs and attitudes on and barriers to utilizing an RRT. RESULTS The survey was analyzed yielding 3 factors: RRT barriers, RRT positive/intent to activate, and patient management beliefs. Barriers cited by other research to activate RRT including criticism by the team and perception that the RRT increases workload or reduces skills were not found to be influential considerations. A significant difference was found among the 3 specialty groups related to RRT positive/intent to activate (F2,159 = 6.09, P = .003) and patient management beliefs (F2,159 = 5.87, P = .003). A strong negative correlation was found between years of experience as an RN and RRT barriers (ρ161 = -0.250). CONCLUSIONS Organizations should examine RRT activation delays particularly in the area of calls to covering physicians prior to RRT activations. Differences between specialty groups highlight the need for education across specialties on the recognition of the acutely deteriorating patient. The findings indicate that the inexperienced nurse requires support from experienced colleagues and temporary adjustments to workload during situations of acute deterioration of a patient.

UI MeSH Term Description Entries
D009741 Nursing Staff, Hospital Personnel who provide nursing service to patients in a hospital. Hospital Nursing Staff,Hospital Nursing Staffs,Nursing Staffs, Hospital,Staff, Hospital Nursing,Staffs, Hospital Nursing
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D006764 Hospitals, Community Institutions with permanent facilities and organized medical staff which provide the full range of hospital services primarily to a neighborhood area. Community Hospital,Community Hospitals,Hospital, Community
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001291 Attitude of Health Personnel Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc. Staff Attitude,Attitude, Staff,Attitudes, Staff,Health Personnel Attitude,Health Personnel Attitudes,Staff Attitudes
D057209 Hospital Rapid Response Team Multidisciplinary team most frequently consisting of INTENSIVE CARE UNIT trained personnel who are available 24 hours per day, 7 days per week for evaluation of patients who develop signs or symptoms of severe CLINICAL DETERIORATION. Cardiac Crash Team,Code Team,Hospital Medical Emergency Team,Medical Emergency Team, Hospital,Rapid Response Team,Cardiac Crash Teams,Code Teams,Crash Team, Cardiac,Crash Teams, Cardiac,Rapid Response Teams,Response Team, Rapid,Response Teams, Rapid,Team, Code,Team, Rapid Response,Teams, Code,Teams, Rapid Response

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