Rapid Response Team?!?!

[Okami_CCRN]

So... my facility has recently implemented the Rapid Response Team which is supposed to be the precursor of a code blue.

Only problem is most people either call the RRT to late or call the RRT when they should have called a code blue.

Anyone else use this RRT thing before and if so how did the implementation go with the Nursing Staff?

BTW when RRT is paged overhead the following people respond:

1 ICU Nurse

2 Resp Therapists

Resident covering unit

Nursing Supervisor

and any Nurse Specialists currently in facility

They might as well call a code lol

[ONCRN84]

We haven't had RRTs for that long and they're going well. There's no "set" criteria, but if you feel like your patient is heading downhill, it's supposed to be called before you have to end up coding them. I called an RRT once for a seizure that wouldn't end (in a pt with known seizure disorder). I've seen them called for respiratory distress, really low BP with symptoms, etc. There are some people who can't trouble shoot for themselves and call them all the time and way too early. Ok, so the sat sucks on RA... put some 02 on?? Get it stable and call the doctor?

I've also seen people get chewed out for calling an RRT on a no code patient.

Our floor is usually pretty good at catching a problem before it becomes a code, calling an RRT, then getting the patient off to the unit before they actually code.

For ours these people come

ICU nurse

Respiratory

Supervisor

Pharmacist

Shift coordinator for the floor

No docs come unless you page the patient's doc and they happen to be in the hospital.

Give your facility time to get used to it. At first it might not be people's thought to call before they code. Eventually people will learn how to use the system and it can be pretty beneficial.

[S.T.A.C.E.Y, LPN]

We did an enormous teaching campaign on calling the RRT for all staff, when to call- "It's always the right call."

I think education would definitely be the critical part of rolling out a RRT program. I like the quote you posted! Although, no its not ALWAYS the right call (as the previous poster pointed out....."did you try some O2 first???") I think the important part would be getting people to call, later the problem of those who call inappropriately can be taken up on an individual matter.

[Zee_RN, BSN, RN]

Our facility instituted RRTs over a year ago. The ICU Charge Nurse (which I was) and a respiratory therapist respond. The supervisor will come along too. There was an adjustment period and there was intensive training for the ICU nurse to make sure the nurse calling the RRT was made to feel VALUED and never criticized for calling the RRT. Emphasis was placed on making the floor nurse comfortable with calling if she felt her patient needed help and she was unable to fix it herself or get the help she was looking for from the doctor. And codes have DEFINITELY been reduced. Better to call--and call early--than NOT call. Our ICU staff is excellent in educating the floor nurse and always thanks them for calling the RRT because we'd rather the staff call when it wasn't warranted than miss a call when it IS warranted.

We have criteria too but one of them is something like "your gut tells you something bad is pending...." (definitely not worded that way, lol, but you get the gist).

[Nightcrawler, BSN, RN]

I love the RRT and have since the very beginning, about two years ago. We don't have any set criteria for calling RRT's at my facility- and some of the criteria stated in previous posts sounds a littlet aggressive to me- but I work on a cardiac floor and we have protocols for chest pain, and would wait for a call for the doc for a hypertensive patient or a hypotensive patient without symptoms. The system works well for us, and rarely is it mis-used.

It is great to have a team of people that are there to come and see the patient that isn't actually coding- but needs someone to look at them RIGHT NOW. I feel that we are often able to prevent codes, and thus potentially save lives, by having people in house that are able to implement immediate actions. I also feel that it is a good intermediate step, and that many of the same situations that may have been called as codes in the past are now aggressively treated as rapid responses.

I do have to say that it is important to not feel the RRT was a failure if it turns into a code. It does not necessarily mean that the nurse missed something or that the RRT was called too late. These are patients that were headed in that direction fast anyway. Without the availability of a RRT many of these patients would not have made it. With the RRT interventions are started, and people are on hand if the patient does code, thus increasing the chances of patient survival.

What I do dread is the implementation of the next piece of the Rapid Response idea as now required as part of the national patient safety goals- that the patient or the family be able to call the rapid response themselves. I am having visions of RRT's called for warm blankets and pain medications....... Oh boy oh boy

[JHRN2BE]

We have RRT's at our facility (large pedi hospital in Houston) and they work great. We do not have specific parameters as far as VS go, but there are guidelines such as rapid change in condition, family/parent concern, etc. I have called several and they work fantastic to help get the patient transferred to an ICU environment rapidly, if needed. We call *9999 and tell the operator we are calling an RRT and to what room. Nothing is broadcast overhead EVER. It is all done through pagers/spectralink as to not alarm patients/families. Who responds...NICU MD, Residents, RT's, NAC's, Charge RN (who is involved when calling RRT), PCA's. It is fast and effective. I am grateful for RRT's as I have had 2 out of the 3 pt's I have called RRT's on be transferred to PICU.

[gal220RN, BSN, RN]

I know giving families the power to call their own RRT is scary, but I think it can be

a critical piece of patient safety. We all have fears of being summoned for blankets, juice and TV malfunctions. However, if the education is adequately done on an elementary level, you should have appropriate uses of the RRT. There will be some calls whose scope will fall outside our purpose.

I had mentioned in a previous post regarding RRT and IHI (Institute for Healthcare Improvement), a video available from http://www.ihi.org, called "The Josie King Story."

This short video will absolutely convince you of the need for parents to call RRT's when needed. Please Please!!! Go to the website and check it out. Bring your kleenex!

Let me also encourage any of you who are using RRT or responding to RRT, the idea behind them from IHI was that an RRT is never a wrong call. Even if you are called to 'put eyes' on a patient to reassure a nurse she is making the right assessments and intervening appropriately, always be gracious. There are always opportunities to learn and to teach.

Godspeed

[gal220RN, BSN, RN]

I know giving families the power to call their own RRT is scary, but I think it can be

a critical piece of patient safety. We all have fears of being summoned for blankets, juice and TV malfunctions. However, if the education is adequately done on an elementary level, you should have appropriate uses of the RRT. There will be some calls whose scope will fall outside our purpose.

I had mentioned in a previous post regarding RRT and IHI (Institute for Healthcare Improvement), a video available from http://www.ihi.org, called "The Josie King Story."

This short video will absolutely convince you of the need for parents to call RRT's when needed. Please Please!!! Go to the website and check it out. Bring your kleenex!

Let me also encourage any of you who are using RRT or responding to RRT, the idea behind them from IHI was that an RRT is never a wrong call. Even if you are called to 'put eyes' on a patient to reassure a nurse she is making the right assessments and intervening appropriately, always be gracious. There are always opportunities to learn and to teach.

Godspeed