2.50
Hdl Handle:
http://hdl.handle.net/10755/308712
Category:
Abstract
Type:
Presentation
Title:
An Evidence-Based Project to Redesign a Rapid Response Team
Author(s):
LaFaro, Maria C.
Lead Author STTI Affiliation:
Epsilon Xi
Author Details:
Maria C. LaFaro, DNP, RN, ANP-BC, maria_lafarokelly@urmc.rochester.edu
Abstract:

Poster presented on: Tuesday, November 19, 2013, Monday, November 18, 2013

Background:  Hospitalized patients are vulnerable to clinical deterioration and errors.  There exists an inadequate response to recognize and treat critical illness in hospitals.  The majority of patients who suffer cardiac arrest experience measurable clinical deterioration hours preceding the event, such deterioration is rarely reported to providers.  Rapid response teams (RRTs) have been widely implemented to avoid this failure to rescue.  The intensity of calls to RRTs is inversely correlated with cardiac arrest and mortality rates.

Aim:  To redesign an existing but underutilized RRT in a large academic, Magnet designated, tertiary care medical center in an effort to increase call volume and intensity.

Methods:  An evidence-based approach was used to formalize a dedicated, interprofessional RRT and to design a trigger-driven system (TDS) to mandate calls based on physiologic criteria and/or nurse worry.  The Synergy Model of Patient Care and the Model for Evidence-Based Practice Change served as theoretical frameworks for the project. The TDS was evaluated on one inpatient unit for a period of six weeks.  Rates of RRT calls were monitored and compared to rates in the same period of the preceding year, and to the rates observed in the months preceding the change.

Results: Calls to the RRT increased substantially.  Before RRT formalization, institutional call rates ranged from 1.21-4.12 calls/1000 discharges (d). RRT formalization increased rates to 18.82-32.53calls/1000d, implementation of the TDS further increased rates to 30.51-37.49calls/1000d. 

Conclusions: The use of research evidence, theory, and organizational experience facilitates evidence-based practice changes. Formalization of the RRT and implementation of a TDS increased call volume.  Improvements in call volume should reduce failure to rescue events and improve patient outcomes. Implementation of a mandated TDS within an organization would likely require significant organizational support and infrastructure.  Evidence-based formalization of the RRT may improve call volumes without the need to mandate calls.

Keywords:
Physiologic Triggers; Rapid Response Teams; Evidence Based Practice
Repository Posting Date:
19-Dec-2013
Date of Publication:
19-Dec-2013
Conference Date:
2013
Conference Name:
42nd Biennial Convention
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Indianapolis, Indiana, USA
Description:
42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriott
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleAn Evidence-Based Project to Redesign a Rapid Response Teamen_GB
dc.contributor.authorLaFaro, Maria C.en_GB
dc.contributor.departmentEpsilon Xien_GB
dc.author.detailsMaria C. LaFaro, DNP, RN, ANP-BC, maria_lafarokelly@urmc.rochester.eduen_GB
dc.identifier.urihttp://hdl.handle.net/10755/308712-
dc.description.abstract<p>Poster presented on: Tuesday, November 19, 2013, Monday, November 18, 2013</p><b>Background:</b>  Hospitalized patients are vulnerable to clinical deterioration and errors.  There exists an inadequate response to recognize and treat critical illness in hospitals.  The majority of patients who suffer cardiac arrest experience measurable clinical deterioration hours preceding the event, such deterioration is rarely reported to providers.  Rapid response teams (RRTs) have been widely implemented to avoid this failure to rescue.  The intensity of calls to RRTs is inversely correlated with cardiac arrest and mortality rates. <p><b>Aim:</b>  To redesign an existing but underutilized RRT in a large academic, Magnet designated, tertiary care medical center in an effort to increase call volume and intensity. <p><b>Methods:  </b>An evidence-based approach was used to formalize a dedicated, interprofessional RRT and to design a trigger-driven system (TDS) to mandate calls based on physiologic criteria and/or nurse worry.  The Synergy Model of Patient Care and the Model for Evidence-Based Practice Change served as theoretical frameworks for the project. The TDS was evaluated on one inpatient unit for a period of six weeks.  Rates of RRT calls were monitored and compared to rates in the same period of the preceding year, and to the rates observed in the months preceding the change. <p><b>Results: </b>Calls to the RRT increased substantially.  Before RRT formalization, institutional call rates ranged from 1.21-4.12 calls/1000 discharges (d). RRT formalization increased rates to 18.82-32.53calls/1000d, implementation of the TDS further increased rates to 30.51-37.49calls/1000d.  <p><b>Conclusions: </b>The use of research evidence, theory, and organizational experience facilitates evidence-based practice changes. Formalization of the RRT and implementation of a TDS increased call volume.  Improvements in call volume should reduce failure to rescue events and improve patient outcomes. Implementation of a mandated TDS within an organization would likely require significant organizational support and infrastructure.  Evidence-based formalization of the RRT may improve call volumes without the need to mandate calls.en_GB
dc.subjectPhysiologic Triggersen_GB
dc.subjectRapid Response Teamsen_GB
dc.subjectEvidence Based Practiceen_GB
dc.date.available2013-12-19T17:35:05Z-
dc.date.issued2013-12-19-
dc.date.accessioned2013-12-19T17:35:05Z-
dc.conference.date2013en_GB
dc.conference.name42nd Biennial Conventionen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationIndianapolis, Indiana, USAen_GB
dc.description42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriotten_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
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