Need help with rapid response team

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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.

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Is anybody familiar with this concept? We have an article that states that this started in Austrailia and significantly cut down on fatalitites and the number of crash/code situations in the floor.

The first 6 hours are the critical period in MI and also CVA, with many resp distress situations that trun onto resp arrest these were also averted or pts were in Critical care when they were coded which make for a much smoother code and better outcome.

The idea is that a select group of CCU nurses will be in the RR team and one will be on each shift. The floor can call you first when they suspect any of the above problems and that a Pt may require CCU. I assume that the hope is that when a floor nurse notices a Pt with a potential problem they will be able to call for the RR team member to come and assess the Pt. This will do 2 things hopefully, 1. Allow the floor nurse to continue taking care of the rest of their Pt load knowing that someone is coming to further assess the situation. 2. In the event of a need for CCU the team member will make the call to the physician and recieve orders and possible make the transfer arrangements(I am not sure how much of this wil be done).

If anyone has any experience with this type situation any info appreciated.

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http://www.ihi.org/IHI/Topics/Improvement/MoveYourDot/ImprovementStories/BuildingRapidResponseTeams.htm

It explains the concept quite well.

Do any of you have anything like this?

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I am bumping this for interest. I really need to know if anyone does this? If your facility doesn't do this let me know that

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Specializes in CCU (Coronary Care); Clinical Research.

We don't do this at my hospital...Currently, if a patinet on the floor is having difficulty, the RN can call RT to evaluate/assist and call the dr. to have the patient transferred...If it is bad enough they may call ahead "pre-code" to get one of us there (but that rarely happens). Usually the patient is either transferred before they code and cared for in CCU or the patient codes and one from CCU/ICU/ER all go to run the code. IT is an interesting system that you mention...but who watches your patients while you are helping on the floor?

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We don't do this at my hospital...Currently, if a patinet on the floor is having difficulty, the RN can call RT to evaluate/assist and call the dr. to have the patient transferred...If it is bad enough they may call ahead "pre-code" to get one of us there (but that rarely happens). Usually the patient is either transferred before they code and cared for in CCU or the patient codes and one from CCU/ICU/ER all go to run the code. IT is an interesting system that you mention...but who watches your patients while you are helping on the floor?

Good points. We are just experimenting with this idea. The question of who watches your Pts while you are away is a goods one. Right now we are assmuing that it will be like having someone cover during a lunch, but of course if the team member has the busiest Pts on the uit it could cause big trouble.The other thing you mentioned is the goal. We are wanting to set up a system in which Pts that are going to code(if we can pre-determine this)will already be in the unit. Stats show a much better outcome when the Pt is in CCU for the actual code.

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We started having a rapid response nurse on nights a few months ago and it seems to be working well. An ICU nurse is on a portable phone for anyone to call for advice. The first few hours they visit all the patients discharged from the intensive care units the previous day to see how they are doing and how their experience was. There are flyers in every nurses station in the hospital w/ the portable phone #.

Nurses call, expecially for help with a deteriorating patient until a doc can be reached. It often results in a transfer down to ICU. In the meantime, the patient can be assessed, suctioned, whatevever extra attention they need.

My only advice is for the ICU rapid response nurse to be kind to the floor nurses instead of berating them. They either forgot or never knew what it is like to have five to nine patients in varying states of neediness.

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We started having a rapid response nurse on nights a few months ago and it seems to be working well. An ICU nurse is on a portable phone for anyone to call for advice. The first few hours they visit all the patients discharged from the intensive care units the previous day to see how they are doing and how their experience was. There are flyers in every nurses station in the hospital w/ the portable phone #.

Nurses call, expecially for help with a deteriorating patient until a doc can be reached. It often results in a transfer down to ICU. In the meantime, the patient can be assessed, suctioned, whatevever extra attention they need.

My only advice is for the ICU rapid response nurse to be kind to the floor nurses instead of berating them. They either forgot or never knew what it is like to have five to nine patients in varying states of neediness.

Thanks for the input. This is really one of my biggest fears that the floor nurses will resent the implication, I mean you know the whole,

I can call a doc as well as they can, why should I need another nurse to check my patient? I can do the same things this nurse can do!

I want to start by going to the floors and having an inservice with the charge nurses and explaining the team and asking if they feel this could be a helpfull resource.

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We don't do this at my hospital...Currently, if a patinet on the floor is having difficulty, the RN can call RT to evaluate/assist and call the dr. to have the patient transferred...If it is bad enough they may call ahead "pre-code" to get one of us there (but that rarely happens). Usually the patient is either transferred before they code and cared for in CCU or the patient codes and one from CCU/ICU/ER all go to run the code. IT is an interesting system that you mention...but who watches your patients while you are helping on the floor?

We had another meeting yesterday and for now it seems like they are just going to make it the CCU charge nurse that is the responder, the admin. is strongly stressing that it be a "come-along-side" program we are not to go and take over the situation and we are to involve the primary nurse with initial reassessment, and sort of try to treat it like a teaching experience. You know like Ok so what did you see that prompted you to call? What has been baseline previously? What kinds of things do you think could cause what we're seeing? Sort of make suggestions after reassessment. They are stressing it as a resource and that we just assist and not assume care, we can offer to make calls to the doc or just explain what we think the doc would need to know. My biggest problem is that we will not have any standing orders to cover the situation.

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We're in the process of forming the team. As I know more I'll update the link. Right now, like you, we are gathering information. THIS THREAD HELPED!

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We're in the process of forming the team. As I know more I'll update the link. Right now, like you, we are gathering information. THIS THREAD HELPED!

I guess my previous posty mad it sound like just the charge nurse, actually it will be the CCU Charge and the RT Manager.

Ok here is the plan as it is now. March 7 for 3 weeks from 7-3 only they will pilot the program for med-surg floors. During this time there will be the CCU charge, 2 CNS(clinical nurse specialist)and the RT manager. The CNS are supposedly going to be there to help make it a teaching experience. Then after that 3 weeks it will be 3 weeks for 24/7 but still just med-surg. Then in May we go full time hospital wide.

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We're in the process of forming the team. As I know more I'll update the link. Right now, like you, we are gathering information. THIS THREAD HELPED!

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.

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