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How RNs rescue patients: a qualitative study of RNs' perceived involvement in rapid response teams
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  1. Linda Searle Leach1,
  2. Ann Mayo2,
  3. Maria O'Rourke3
  1. 1UCLA School of Nursing, Los Angeles, California, USA
  2. 2Philip Y Hahn School of Nursing and Health Science, University of San Diego, San Diego, California, USA
  3. 3UCSF & UCLA School of Nursing, Maria W O'Rourke, Larkspur, California, USA
  1. Correspondence to Dr Linda Searle Leach, UCLA School of Nursing, 700 Tiverton Avenue Factor Bldg 3-234, Los Angeles, CA 90095-6917, USA; lleach{at}sonnet.ucla.edu

Abstract

Background Patients are admitted to hospitals everyday with clinical conditions that can change dynamically resulting in adverse outcomes. The rapid response team (RRT) intervention is a formalised resource to respond to the nurse's concerns about such patients before code arrest occurs. Registered nurses (RNs) are in a position to recognise critical changes and to rescue patients at the most opportune moments, but little is known about how RNs rescue patients using these increasingly popular teams. Our aims were to investigate how RNs rescue patients in hospitals where RRTs are in place.

Methods Fifty participants involved with RRTs participated in semistructured individual interviews in six California hospitals. Data were analysed using coding and constant comparison methods.

Results Overall, RNs view RRTs as a helpful and effective safety intervention. RRT RNs and bedside RNs support one another in a synergistic way to prevent adverse patient events during the rescuing process. However, traditional hierarchies and relationships with physicians and supervisors impede some components of RN decision-making during rescuing.

Conclusions RNs find the RRT supportive when their patient is at risk or care needs are changing. They benefit from a formalised mechanism that enables immediate access to resources. RRT RNs in this study applied their expertise with critically ill patients to rescue medical and surgical patients. The RRT RN and bedside RNs' interaction influenced the rescuing process. Their role synergy was a value-added contribution to preventing adverse events and to improving patient safety by RNs.

  • Rescuing
  • rapid response teams
  • patient safety
  • RN role

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Footnotes

  • Funding Funding provided by the Gordon and Betty Irene Moore Foundation. The funding source had no involvement, and the authors' work is independent of the funders. The funding was provided to the Association of California Nurse Leaders who served as the sponsor of the study. The sponsor had no role in the study design, collection, analysis or interpretation of data, writing the report or in the decision to submit the article for publication.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by each hospital site IRB and UCLA IRB.

  • Provenance and peer review Not commissioned; externally peer reviewed.