ENHANCING EFFECTIVENESS OF RAPID RESPONSE TEAM ACTIVATIONS

A number of hospitals across the United States have adopted the use of rapid response teams (RRTs) to immediately assist patients experiencing clinical decompensation outside intensive care units and prevent failure-to-rescue events such as cardiorespiratory arrest and death. While conceptualization of the RRT is consistent in many studies, there is a lack of consensus regarding RRT activation criteria for clinical instability. The aim of this study was to evaluate the effectiveness of the Modified Early Warning Score (MEWS) tool, a multiple trigger system developed in a medical center, to identify factors that would alert the staff nurse to seek RRT assistance. With the goal to evaluate the MEWS impact on RRT activations and enhance the effectiveness of activation calls, this retrospective study involved data collection over a 3-month period on RRT events (n = 81). Each RRT event was reviewed and assigned a score using the MEWS tool. Based on MEWS score alone, only 8 activations would have occurred. However, 59 activations would have occurred by execution of clinical judgment. Results also demonstrated the average MEWS was only marginally effective in identifying patients having clinical deterioration (p = .05). Patient demographic variables were analyzed to determine their association with clinical deterioration. No association was found between age (p = .20) or presence of comorbidities (OR 0.94, p = .65) and clinical deterioration. It is recommended that revisions to the MEWS may improve its ability to identify patients at risk for clinical deterioration; its adoption has been postponed in the project setting.