Qualitative exploration of nurses' decisions to activate rapid response teams

Authors


Correspondence: Kim S Astroth, Assistant Professor, Mennonite College of Nursing at Illinois State University, Campus Box 5815, Normal, IL 61790-5815, USA. Telephone: +1 309 438 2367.

E-mail: kmastro@ilstu.edu

Abstract

Aims and objectives

To identify barriers and facilitators to nurses' decisions regarding activation of rapid response teams (RRTs) in hospitals.

Background

Hospitalised patients in the United States who experience cardiopulmonary arrest seldom recover. Most of these patients show signs of clinical deterioration prior to cardiopulmonary arrest. RRTs have been shown to decrease the incidence of cardiopulmonary arrest by bringing needed resources to unstable patients. Despite the evidence in support of the activation of RRTs, nurses do not always use this resource. Nurses' decisions to activate or not to activate the RRT are not clearly understood.

Design

We used a qualitative design for this study.

Methods

A purposive sample of 15 medical/surgical nurses was recruited from a small medical centre in the Midwest. Researchers used semistructured, open-ended questions to elicit subject responses regarding facilitators and barriers to activating RRTs.

Results

Themes emerged and were categorised as facilitators and barriers to calling the RRT. Facilitators and barriers were then subdivided into distinct subthemes: RRT characteristics and unit culture. The expertise of the RRT members and support and encouragement from nursing unit colleagues and leaders emerged as two potential facilitators. Communication of the RRT members and calling the physician first emerged as two potential barriers. We also identified educational factors that were not clearly facilitators or barriers to calling the RRT.

Conclusions

Further study is needed using quantitative designs with larger sample sizes.

Relevance to clinical practice

Nurses can build upon knowledge of facilitators and barriers related to RRT characteristics and nursing unit culture.

Ancillary