nursing research on rapid response teams

1. 2 nd Annual Nursing Research & Evidence-Based Practice
Symposium
Promoting Nursing’s Future:
Building Bridges from Classrooms to Clinical Settings

2. An assessment of nurses
attitudes towards rapid response
teams (2009)
Daniel Ampomah, RN, PhD, NE-BC
Phillip Eaton, RN, MSN, RRT
Rodica Sandor-Scoma, RN, MSHA, MD.
Zewdensh Bryant, RN, BSN, MS.

3. MSET/RRT Data 2005-2007
TOTAL MSETs AND RRTs 2005-2007
299
300
TOTAL MSETs
250
200 190
150
100 77
74
44 51
50 30 37 40
23 28
0
0
TOTAL 2005 TOTAL 2006 TOTAL 2007
YEAR
CCU NON CCU TOTAL RRT

4. MSET/RRT Data 2007-2008
2007-2008 MSETs AND RRTs
15 35
30
MSETs
25
10
20
RRTs
15
5
10
5
0 0
Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Jan
RRT/ 500 dc 7.704 9.404 13.90 27.77 30.67 22.76 19.72 14.01 23.92 20.58 21.00 29.74
CCU MSET 3 1 4 0 6 2 0 0 0 1 2 4 2
Non CCU 4 2 0 2 2 3 3 2 3 2 2 3 7
RRT/ 500 dc CCU MSET Non CCU

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

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

7. Research questions
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?

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

9. Inclusion & exclusion criteria
Employed and
Working as an Travelers, contract or
RN or LPN at agency per diem
IMVH nurses working at
IMVH

10. Instruments
 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

11. Data collection & analysis
 Paper survey
 Descriptive statistics employing
frequencies and percentages was
used to answer the research
questions.

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

13. Sample Matrix
Age of Gender Race/Ethnicity Employment Yrs nursing Years
respondents status practice worked
at IMVH
Youngest Male African- Full time 1-5 yrs 1-5yrs
respondent was 13 (9%) American/Black 91 (66%) 24% 85 (62%)
24 years old 63 (46%)
Oldest Female Asian/Pacific Islander Part time 6-10yrs 6-10 yrs
respondent was 126 (91%) 18 (13%) 21 (15%) 21% 38 (28%)
65 years old
Mean age of the Caucasian/White PRN 11-15yrs Over 10yrs
sample was 43 47 (34%) 27 (19%) 16% 14 (10%)
yrs
Hispanic/ Latino 16-20yrs
2 (1%) 18%
Other 21-30yrs
8 (6%) 15%
31-47 yrs
7%

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

15. MAJOR
FINDINGS

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

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

18. Usefulness of the RRT for the
nursing staff
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.

19. Obstacles to the nurses using the
RRT service
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.

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

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

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

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

24. Thank You

25. Questions?