Need help with rapid response team

Specialties CCU

Published

We are trying to devise a plan of action for starting a Rapid response team. If you have one or have worked at a facility that has had one I would love to hear your input.

Does it work?

How does it work?

How did you set it up?

Did you have standing orders from the beginning?

Did your CCU staf provide the staff for this?

Any and all help appreciated.

Specializes in Critical Care Baby!!!!!.

i am the nurse clinician in the icu where i work. i have been at this hospital for about a year. this hospital uses a response team. they call the emergency response team. if any nurse in the hospital feels that they are having trouble with their patient; they have the operator overhead page for the ert to come to such and such a room. the other option they have is call the house supervisor to put the ert in motion.

the ert is made up of icu nurses and an rt if necessary. we go and evaluate the patient and the current situation. if need be we call the icu for a bed and transfer the patient. i have to be honest though, this happens rarely. for the most part we fix whatever problem is at hand and keep the patient from getting into trouble. just the other day i responded to an ert. pt was tachycardic and diaphoretic, rate was in the 130's. i called the cardiologist and got an order for iv lopressor. rate came down after about 5 minutes and the patient felt much better. this ended up saving an icu bed for someone who really needs it. i think this works great! this is the first hospital that i worked in that has this. i think it's a great idea.

1) the rapid response nurse does not assume pt care. We have about a half dozen volunteers, and they are the RRRN on a rotating basis. It would be stupid to have the charge nurse do it. Who's running the ICU for 30-45 minutes while they're off the floor?

2) We never "take over care" we are there to assist the floor nurse. I have seen floor nurses say "I didn't think to NT suction" or whatever. Critical care nurses are used to that sort of thing. It is no poor reflection on the floor nurse.

3) RT's are great, but what if it's not a respiratory issue? Maybe we can figure it out before it's time to bag 'em. Is an RT going to hook them up to the monitor and diagnose toursades? Is an RT going to address a blood sugar of 20 or 600?

We have a pediatric rapid response team but its a *team* and not a nurse responder. I work in a pedi rehab hospital that's linked with a big teaching university that you all have heard of . Basically when we have a kid that's going downhill, we'll call the HO (house officer) and then we'll call the PRRT. They come over (they = PICU RNs, a pediatrician, RT, anesthesiologist, pharmacist, phlebotomist...), assess the situation, and then they will transport the kid through the tunnel to their PICU.

In essence they are a code team, but we call them before the kid codes. If we get the kid back to normal before they arrive, or they do once they get on the floor, all the better. Its not punitive if you call and they don't think the kid is as bad off as you thought he/she was. The best thing about it is that they do the transport (my worst fear is that a kid will code in the tunnel or elevator en route) and they go directly to PICU instead of stopping in the pedi ER first.

That probably doesn't help, because it sounds totally different than what you're describing. I think its a great idea, though. Nurses that don't deal with codes on a routine basis tend to panic, and I would love to have an experienced PICU nurse with me at times like that.

Good luck with it.

http://www.metproject.org.uk/html/the_met_project_book.html

check this site they really have all their ducks in a row with their protocols and design.

This is really impressive!

The idea is great.

I plan to learn more and present the idea. We informally do similar. The charge nurses on the floors or the shift supervisor will call us in CCU or in the ICU if a nurse has a patient he or she is worried about. Usually one of us will go. The nurse with only one patient leaves the charge nurse temporarily responsible for the patient in the unit.

If the patient comes to the unit the nurse already has report.

Often it is a matter of someone with critical care shiks and the time to assess and intervene preventing a code.

How did I stay so ignorant that other hospitals are doing this in a formal way?

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