Rapid‐response teams (RRTs) are a patient safety intervention designed to identify, diagnose, and treat hospitalized patients who are clinically deteriorating outside an intensive care unit (ICU). The ability to implement and sustain a successful RRT depends on the availability and expertise of the team members. Critical care nurses are integral members of all RRTs, but their ability to participate in such teams may be limited by competing ICU duties, particularly in large academic medical centers with high ICU acuity.
A hospital‐based critical care nursing coordinator model was created to lead an RRT in an academic medical center, assist in patient identification for the RRT, and educate floor nurses on the care of critically ill patients.
Our hospital has traditionally employed administrative nursing coordinators to assist the hospital with bed management and nursing staffing issues. During the development of our RRT, these positions were reorganized in order to assume the clinical role of primary nursing responderforour RRT. Two critical care nursing coordinators were made available during daytime hours during the RRT implementation period and are now available 24 hours a day. The primary duty of the coordinators is to respond to rapid‐response calls. Time between calls is spent rounding on the hospital floors, assisting the nursing staff with clinical issues, helping staff nurses identify patients in need of the RRT, and supporting patient flow initiatives. Standardized triggers for RRT activation have been established and include nursing discretion. In addition to the critical care nurse, the RRT includes a respiratory therapist, a clinical pharmacist, the resident team with primary responsibility for the patient, and a rapid‐response attending based on availability.
From July 2006 to November 2006, 192 RRT calls have been placed. The coordinators have triggered several rapid‐response calls on their own. Many additional calls by floor nurses have been prompted by the coordinators after evaluating patients whom the nurses identified as potentially unstable. The coordinators also provide ongoing education about RRT triggers to the nursing units. Total hospital cardiac arrest volume has decreased from an average of 19.5 arrests per month prior to RRT implementation to 13.8 arrests per month after RRT implementation. ICU cardiac arrest volume has been reduced from 11.5 to 6.8 arrests per month. This represents a 38% reduction in both measurements, when compared with 2 years of historic baseline cardiac arrest data.
The development of a hospital‐based critical care nursing coordinator model may increase RRT utilization and improve outcomes through increased nursing availability, better patient identification, and effects on nursing education and satisfaction.
J. S. Myers, None; J. Phillips, None; B. Sarani, None; S. Brenner, None; A. Fuld, None; J. Torbet, None; V. Rich, None.
To cite this abstract:Myers J, Phillips J, Sarani B, Brenner S, Fuld A, Torbet J, Rich V. Development of a Critical Care Nursing Coordinator Model to Lead a Rapid‐Response Team in an Academic Medical Center. Abstract published at Hospital Medicine 2007, May 23-25, Dallas, Texas Abstract 92. Journal of Hospital Medicine. 2007; 2 (suppl 2). https://www.shmabstracts.com/abstract/development-of-a-critical-care-nursing-coordinator-model-to-lead-a-rapidresponse-team-in-an-academic-medical-center/. Accessed May 26, 2019.