Rapid response team: what factors interfere with your performance?

Aline A. S. Moreira; Rogiane O. Ramos; Anna Beatriz S. Ligório; Karolina D. Junqueira; Krislainy S. Corrêa

doi:10.17533/udea.iee.v36n2e05

Authors

Aline A. S. Moreira Physiotherapist, Master Student, Federal University of Goiás, Brazil. email: aaliinee.alves@gmail.com
Rogiane O. Ramos Physiotherapist, Multiprofessional Resident of Goiás Clinic Hospital, Federal University of Goiás, Brazil. email: rogiane.fisio@gmail.com
Anna Beatriz S. Ligório Physiotherapist, Multiprofessional Resident of Goiás Clinic Hospital, Federal University of Goiás, Brazil. email: annabsligorio@gmail.com
Karolina D. Junqueira Physiotherapist, Physical Therapist. Emergency Hospital in Goiania, Brazil. email: duarte.karolina@gmail.com
Krislainy S. Corrêa Physiotherapist, Ph.D. Assistant Professor, Pontifical Catholic University of Goiás, Brazil. email: krislainycorrea@hotmail.com

DOI:

https://doi.org/10.17533/udea.iee.v36n2e05

Keywords:

Hospital rapid response team, heart arrest, hospital mortality, critical care.

Abstract

Objective. Describe the knowledge in the literature related to factors that influence the performance of response teams.

Methods. Integrative review of the literature of articles published in Portuguese, English or Spanish between 2006 and 2016. The descriptors hospital rapid response equipment, cardiac arrest and hospital mortality were used for the search in the PubMed/Medline, Lilacs - Bireme and CINAHL bibliographic databases.

Results. 19 studies were included for the analysis. The results were categorized in: sociocultural barriers and institutional policies, late activation of the rapid response team, composition and/or strengthening of the team’s capacity, and use of facilitating tools. The sociocultural barriers found were: the presence of interprofessional hierarchies and beliefs, the limitations of institutional policies were related to the lack of training and human resources deficit. Late activations increased mortality, duration of hospitalization, and admission to the intensive care unit. The teams composed of intensive care professionals showed a reduction in mortality and in the occurrence of cardiac arrest. The use of new tools did not promote changes in the response of the team.

Conclusion. The factors found in this review influence the performance of the rapid response team. The foregoing should be taken into account to improve the survival of patients who require this type of care.

How to cite this article: Moreira AAS, Ramos RO, Ligório ABS, Junqueira KD, Corrêa KS. Rapid response team: what factors interfere with its performance? Invest. Educ. Enferm. 2018; 36(2):e05.

|Abstract

= 2206 veces | PDF

= 1176 veces| | HTML ENGLISH

= 6 veces| | VIDEO

= 0 veces|

Downloads

Download data is not yet available.

References

(1) O´horo JC, Berrios RAS, Elmer JL, Velagapudi V, Caples SM, Kashyap R, et al. The role of the primary care team in the rapid response system. J. Crit. Car. 2015; 30:353-57.

(2) Devita MA, Bellomo R, Hillman K, Kellum J, Rotondi A, Teres D, et al. Findings of the first consensus conference on medical emergency teams. Crit. Care Med. 2006; 34(9):2463-78.

(3) Ludikhuize J, Brunsveld-reinders AH, Dijkgraaf MGW, Smorenburg SM, de Rooij SE, Adams R, et al. Outcomes associated with the nationwide introduction of rapid response systems in the Netherlands. Crit. Care Med. 2015; 43(12):2544-51.

(4) Simmes FM, Schoonhoven L, Mintjes J, Fikkers BG, van der Hoeven JG. Incidence of cardiac arrests and unexpected deaths in surgical patients before and after implementation of a rapid response system. Ann. Intensive Care. 2012; 2(20):1-6.

(5) Maharaj R, Raffaele I, Wendon J. Rapide response systems: a systematic review and meta-analysis. Crit. Care. 2015; 19:1-15.

(6) Braaten JS. Hospital System Barriers to Rapid Response Team Activation: A Cognitive Work Analysis. Am.J.Nurs. 2015; 115(2):22-32.

(7) Shearer B, Marshall S, Buist MD, Finnigan M, Kitto S, Hore T, et al. What stops hospital clinical staff from following protocols? An analysis of the incidence and factors behind the failure of bedside clinical staff to activate the rapid response system in a multi-campus australian metropolitan healthcare service. BMJ Qual. Saf. 2012; 21(7):569-75.

(8) Akhtar N, Field RA, Greenwood L, Finnigan M, Kitto S, Hore T, et al. Quality of in-hospital cardiac arrest calls: a prospective observational study. BMJ Qual. Saf. 2012; 21:184-90.

(9) Barwise A, Thonpprayoon C, Gajic O, Jensen J, Herasevich V, Pickering BW. Delayed rapid response team activation is associated with increased hospital mortality, morbidity, and length of stay in a tertiary care institution. Crit. Care Med. 2016; 44(1):54-63.

(10) Chen J, Bellomo R, Flauboris A, Hillman K, Assareh H, Ou L. Delayed emergency team calls and associated hospital mortality: a multicenter study. Crit. Care Med. 2015: 43(10):2059-65.

(11) Chen J, Bellomo R, Flauboris A, Hillman K, Finfer S. The relationship between early emergency team calls and serious adverse events. Crit. Care Med. 2009; 37(1): 148-53.

(12) Tirkkonen J, Yla-Mattila J, Olkkola KT, Huhtala H, Tenhunen J, Hoppu S. Factors associated with delayed activation of medical emergency team and excess mortality: an utstein-style analysis. Resuscitation. 2013; 84:173-8.

(13) Al-Qahtani S, Al-Dorzi HM, Tamim HM, Fong L, Taher S, Al-Knawy BA, et al. Impact of an intensivist-led multidisciplinary extended rapid response team on hospital-wide cardiopulmonary arrests and mortality. Crit. Care Med. 2013; 41(2):506-17.

(14) Dacey MJ, Mirza ER, Wilcox V, Doherty M, Mello J, Boyer A, et al. The effect of a rapid response team on major clinical outcome measures in a community hospital. Crit. Care Med. 2007; 35(9):2076-82.

(15) Jung B, Daurat A, De Jong A, Chanques G, Mahul M, Monnin M, et al. Rapid response team and hospital mortality in hospitalized patients. Intensive Care Med. 2016; 42: 494-504.

(16) Morris DS, Schweickert W, Holena D, Handzel R, Sims C, Pascual JL, et al. Differences in outcomes between ICU attending and senior resident physician led medical emergency team responses. Resuscitation. 2012; 83: 1434-37.

(17) Hatlem T, Jones C, Woodard EK. Reducing mortality and avoiding preventable ICU utilization: analysis of a successful rapid response program using APR DRGs. J. Health Qual. 2011; 33(5):7-16.

(18) Sebat F, Musthafa AA, Johnson D, Kramer AA, Shoffner D, Eliason M, et al. Effect of a rapid response system for patients in shock on time to treatment and mortality during 5 years. Crit. Care Med. 2007; 35(11):2568-75.

(19) Davis DP, Aguilar SA, Graham PG, Lawrence B, Sell RE, Minokadeh A, et al. A novel configuration of a traditional rapid response team decreases non–intensive care unit arrests and overall hospital mortality. J. Hosp. Med. 2015; 10(6):352-57.

(20) Calzavacca P, Licari E, Tee A, Egi M, Downey A, Quach J, et al. The impact of rapid response system on delayed emergency team activation patient characteristics and outcomes - a follow-up study. Resuscitation. 2010; 81:31-5.

(21) Chen J, Ou L, Hillman K, Flabouris A, Bellomo R, Hollis SJ, et al. The impact of implementing a rapid response system: a comparison of cardiopulmonary arrests and mortality among four teahing hospitals in Australia. Resuscitation. 2014; 85:1275-81.

(22) Kollef MH, Chen Y, Heard K, LaRossa GN, Lu C, Martin NR, et al. A randomized trial of real-time automated clinical deterioration alerts sent to a rapid response team. J. Hosp. Med. 2014; 9(7):424-9.

(23) O´connell A, Flauboris A, Kim SW, Horwood C, Hakendorf P, Thompson CH. A newly designed observation and response chart’s effect upon adverse inpatient outcomes and rapid response team activity. Intern. Med. 2016; 1:909-16.

(24) Kansal A, Havill K. The effects of introduction of new observation charts and calling criteria on call characteristics and outcome of hospitalised patients. Crit. Care Resusc. 2012;14:38-43.

(25) Bertaut Y, Campbell A, Goodlett D. Implementing a rapid-response team using a nurse-to-nurse consult approach. J. Vasc. Nurs. 2008; 26(2):37-42.

(26) Singh S. In Reference to “A novel configuration of a traditional rapid response team decreases non–intensive care unit arrests and overall hospital mortality”. J. Hosp. Med. 2015; 10(10):703.

(27) Astroth KS, Woith WM, Stapleton S, Degitz RJ, Jenkins SH. Qualitative exploration of nurses’ decisions to activate rapid response teams. J. Clin. Nurs. 2013; 22: 2876-82.

(28) Macnaughton K, Chreim S, Bourgeault IL. Role construction and boundaries in interprofessional primary health care teams: a qualitative study. BMC Health. Serv. Res. 2013;13:486.

(29) Shekelle PG. Nurse–patient ratios as a patient safety strategy: a systematic review. Ann. Intern. Med. 2013; 158: 404-9.

(30) Buist M, Marshall S, Shearer B, Finnigan M, Hore T, Sturgess T, et al. Getting more efficient Rapid Response System (RRS) utilization by the use of a general ward based deteriorating patient contract. Saf. Health. 2015; 1:1-8.

(31) Silva R, Saraiva M, Cardoso T, Aragão IC. Medical emergency team: how do we play when we stay? Characterization of MET actions at the scene. Scand. J. Trauma Resus. 2016; 24:1-6.

(32) Rose MA, Hanna LA, Nur SA, Johnson CM. Utilization of electronic modified early warning score to engage rapid response team early in clinical deterioration. J. Nurses Prof. Dev. 2015; 31(3):e1-7.