Published May 4, 2009
Was wondering is anyone using family initiated rapid response? If so, how do you educate them how and when to do it? What about abuse of the system? How is it working?
labcat01, BSN, RN
We technically have it- although, we don't do education on it and I'm sure our patient's families don't know it exists I'm curious to know what others experiences are like.
We have something similar, called "Condition H." We don't seem to have very many called (250-bed, small-city hospital). Most of the ones that are called, are not really emergencies like our nurse-initiated RRT's. So it has generally worked out alright for us. There hasn't been the abuse I thought there might be when we started the program.
Oh, we hand out flyers about it on admission, and the same laminated flyers are on the walls of each room.
We also have something similar, except ours is called "Race team". Our family initiated race team just started about 6 months ago. We have fliers that are to be given on admission and we are required to educate the patient and family about it. Thankfully we have not had much abuse of the system either. We were all very concerned when we first started it, but it has actually been a good thing for us so far! We make sure to explain that it is only to be used for emergency situations, not just because they aren't happy with something.
we also have "condition H".
it works out well, actually, and the information is in the admission pack about when it is appropriate to activate condition H.
we have a process in which our switchboard operator screens the calls and ask what is the problem. if she answers the phone and hears "my grandma's not breathing" or "my dad is having chest pain", she will either call a code blue or a rapid response to the room. if she answers the phone and hears "i need a new box of kleenex" or "no one brought my mom her gingerale", she then calls the charge nurse on the floor and tells them the family was upset enough to active the "condition H" phone and what they wanted.
i haven't had a problem with it so far.
We also have it, there are posters in all the rooms that tell about our "care line" for non-emergent issues and the rapid response, with both numbers. I have not had any issues with bad calls. I think we have only had a couple family initated RRT calls. Not nearly as bad as we all were expecting!!
We have it at our hospital and have had it in place for over a year with very few calls. There are posters in every room and a stick on the back of every phone advertising it, but fortunatley, the nurses and team leaders are more often than not able to prevent situations from reaching the point where a patient or family feels the need to call the FIRRST team. I truly expected to see a lot of abuse of this team, but alas, it has not happened.
nerdtonurse?, BSN, RN
We tried it and got two extremes...the ones that were calling it every 5 minutes because they wanted coke and we only carry pepsi (this is also the same pt who called the kitchen and wanted a dozen muffins sent up to feed her visitors on the RRT line), and a few who called when they thought something was really going wrong. I don't see much emphasis on it now, as much as when they first started the program.
We have a similar system. It's been in place for 6 mos - 1 year now. Each pt gets a pamphlet on admission and that same pamphlet is supposed to be on the bulletin board in each room. I usually tell them that there is a program in place where, if there is a serious change in your condition, and your nurse/doctor is not listening to you, and you feel it is an emergency, you can call this number. I also tell them it is for things like shortness of breath, chest pain, etc - things you would call 9-1-1 for if you were at home. Not for your pain medicine or because you are hungry.
I have not heard of much about it, actually, so I assume it is not being abused. I will have to ask the response nurses about it next time I see them...
MAISY, RN-ER, BSN, RN
Thanks for the responses so far....
What policies have you changed or instituted?
How is patient education implemented?
What is your structure?
Any responses would be appreciated, currently working on a project....it seems that this program was instituted at John's Hopkins after a little girl named Josie King died due to a series of hospital errors and poor communication. The parents re-invested in the hospital with the lawsuit winnings in an effort to prevent future deaths when a parent or family member doesn't feel like their concerns are being listened to. There isn't very much in the way of literature on the subject.
mama_d, BSN, RN
We also have one (called FIRST I think, don't remember what the acronym is for to be honest). There is an educational flyer in each of our admit binders, along with a copy of the flyer up on the wall in the patient's room. I haven't heard of much abuse of it, and the one time that I know it happened risk management got involved and came down on the patient/family for "abuse of emergency services that could negatively impact response to a true emergent situation" or something along those lines.
I believe that it goes out over the pagers just like our rapid response does...which I can see having an impact on those false calls. "Geez, I just wanted a Pepsi, and I ended up with a code cart, twelve nurses, a pharmacist, three RTs, and a doctor in my room...and boy, did they all look p!ssed off at me! Better not do that again!"
Personally, I don't educate people on it, although I should.
We have it. Just started. I think its only been called 2 or 3 times since we started it. and It's not an official RR... only the nursing supervisor comes.
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