From the Guidelines
Rapid response teams should be activated when a patient shows signs of clinical deterioration, and the team should include critical care nurses, respiratory therapists, and physicians who bring ICU-level care to the bedside, as recommended by the Society of Critical Care Medicine guidelines 1. The protocol for a rapid response system (RRS) involves a team of healthcare professionals who respond quickly to deteriorating patients in hospitals.
Key Components of a Rapid Response System
- The team typically includes critical care nurses, respiratory therapists, and physicians who bring ICU-level care to the bedside.
- Activation criteria include abnormal vital signs, such as heart rate <40 or >130, respiratory rate <8 or >30, systolic blood pressure <90, oxygen saturation <90% despite supplementation, acute changes in mental status, or when healthcare staff have significant concern about a patient's condition.
- To activate a rapid response, staff should call the designated hospital number and provide the patient's location and brief clinical situation.
Importance of Rapid Response Systems
- Rapid response teams reduce in-hospital cardiac arrests and mortality by identifying and treating deteriorating patients before they reach critical status, representing a proactive rather than reactive approach to patient care.
- The Society of Critical Care Medicine guidelines recommend hospital-wide deployment of rapid response systems with explicit activation criteria 1.
Education and Quality Improvement
- Focused education for bedside clinicians on recognizing early clinical deterioration is suggested, as well as incorporating patient, family, and care partner concerns into hospital early warning systems 1.
- A process for quality improvement should be part of a rapid response system, including audits, feedback, and education to encourage improvement and compliance with proper measurement techniques, accurate documentation, and prompt response to significant physiologic abnormalities 1.
From the Research
Rapid Response System Protocol
The protocol for a rapid response system (RRS) typically involves a team of specially trained nursing, respiratory, and medical personnel who respond to calls from general care units to assess and manage decompensating or rapidly changing patients before their conditions escalate to a full code situation 2. The team's primary goal is to provide early clinical intervention to mitigate negative patient outcomes and save lives 3.
Key Components of RRS
- Clinical indicators for triggering a rapid response team call, such as changes in vital signs or other signs of deterioration 2
- A team composition that may include a physician, critical care registered nurse, or nurse practitioner 4
- Mandatory or voluntary activation of the team, with mandatory activation directing the team to be called if specific predetermined criteria are observed 4
- Proactive rounds and education of staff by dedicated RRTs to improve outcomes and staff satisfaction 4
Effective Team Performance
Dimensions of effective team performance in RRS include:
- Organizational culture
- Team structure
- Expertise
- Communication
- Teamwork 5 These dimensions are critical to the success of RRS in managing patients at risk or in crisis.
Challenges and Limitations
Despite the potential benefits of RRS, there are challenges and limitations to its implementation, including: