Resident and RN perceptions of the impact of a medical emergency team on education and patient safety in an academic medical center*

Abstract

Residents and RNs believe that a medical emergency team improves patient safety in the hospital without compromising educational experiences or skills. Frequency of involvement in the events and the decision to activate the team correlated with more positive attitudes.

Designing a Critical Care Nurse–Led Rapid Response Team Using Only Available Resources: 6 Years Later

“…This theme, consistent with previously reported data, was also observed by administrators and most providers. 3,35,42,43,46 The mean RRT call duration of 24 minutes in 2012 is similar to what some others have reported. 15,32,46,48,49 Factors contributing to shorter RRT calls include familiarity with the RRT process, development of cohesiveness and trust among team members, and acquisition of expertise by both nurses from general care areas and RRT members through repeated experience of the RRT process.…”

“…They found that nurses working in facilities with wellfunctioning and integrated RRTs did not hesitate to activate it. [42][43][44] Conversely, teams not viewed as cohesive and supportive were less likely to be called because the nursing staff was not confident the team would support their decision to activate the response. 42 Nurses with RRT experience indicate that they initiate RRTs for 3 primary reasons: (1) the patient exhibits signs and symptoms that were either unexpected or significantly different from baseline; (2) the nurse, despite the absence of objective data, thought that something was wrong; and (3) the nurse was convinced that the patient needed immediate intervention and was either unable to reach the physician or unable to obtain appropriate interventions as perceived by the nurse.…”

“…42 Nurses with access to a robust RRT state that if they were changing jobs or a family member required hospitalization, they would select a facility offering an RRT. 32,42,43 Surveys of medical residents and nurses indicate that both agree that the presence of a MET improves patient safety, although the nurses perceived that more strongly than did the residents. [42][43][44][45] Benin and colleagues 45 conducted qualitative open-ended interviews with nurses, physicians, RRT members, and house staff to evaluate their view of RRT impact within a hospital setting.…”

Original Research

“…Improved patient outcomes associated with RRT implementation include decreased cardiac arrest rates outside of Intensive Care Units (ICUs) (Chan et al, 2010), lowered unanticipated ICU admissions (Salamonson, Van Heere, Everett, & Davidson, 2006; Garretson et al, 2006)and decreased hospital mortality rates (Cretikos et al, 2006; Garretson et al, 2006). Organizational outcomes include enhanced quality and safety of care (Berwick, Calkins, McCannon, & Hackbarth, 2006; Sarani et al, 2009; Williams, Newman, Jones, & Woodard, 2011), enhanced nurse satisfaction (Metcalf et al, 2008) and staff collaboration (Williams et al, 2011), and enhanced physician and nurses' skills and knowledge about managing severely ill patients (Azzopardi, Kinney, Moulden, & Tibbals, 2011; Williams et al, 2011). …”

“…Several studies support the linkage between the perception of RRT benefits and RRT activation. Sarani et al (2009) reported that the physicians and nurses who perceived RRTs to improve patient safety were more likely to activate and call the RRT than those who did not perceive these benefits. More recently, Davies, DeVita, Ayinla, & Perez (2014) found that as the perception of benefit from RRT activation increased, adherence rates to activation criteria increased.…”