FACILITY:
SUBJECT:
MOUNTAIN VIEW HOSPITAL DISTRICT
RAPID RESPONSE TEAM (RRT)
DEPARTMENT: NURSING
POLICY OWNER: DIRECTOR QUALITY MANAGEMENT
APPROVED BY: S.BEAN RN BSN
REVIEWED:
REFERENCE #
PAGE: 1
OF: 4
EFFECTIVE: 7/10/2006
REVISED:
PURPOSE:
Reduction of emergency transfers, cardiac arrests and deaths (in nonICU patients) by intervening with a specially trained team before there
is a medical emergency.
DEFINITION:
Team of trained clinicians who bring critical care expertise to the
bedside or wherever it is needed, in order to assess, stabilize, assist
with communication, educate, support and assist with transfer if
necessary. The RRT will be used for areas outside of the ED, OR,
PAR, Newborn and Critical Care areas.
COMPOSITION:
The team will consist of the House Supervisor and the Emergency
Room Physician, and Respiratory Therapy. In house staff should
respond immediately, with no more than a 5 minute delay (unless
involved in a higher priority situation.) The activation of the RRT is
considered an emergency.
CRITERIA TO ACTIVATE: The team may be summoned at anytime by anyone in the
hospital to assist in the care of a patient who appears acutely ill, before
the patient has a cardiac arrest or other adverse event. Nurse caring
for the patient is to call Patient’s PCP after RRT is activated, and
advise them of the situation.
The team should be activated for the following:
1. Any staff member concern about the patient
2. Acute change in urinary output to <50ml in 4 hours for
adults, or less than 0.5cc/kg/hr X 4 hours.
3. Acute change in conscious state
4. Chest pain
5. Airway: Respiratory distress/threatened airway
6. Dysrhythmias
7. Repeated or prolonged seizure > 15 minutes
D:\106743168.doc
FACILITY:
SUBJECT:
MOUNTAIN VIEW HOSPITAL DISTRICT
RAPID RESPONSE TEAM (RRT)
DEPARTMENT: NURSING
POLICY OWNER: DIRECTOR QUALITY MANAGEMENT
APPROVED BY: S.BEAN RN BSN
REVIEWED:
REFERENCE #
PAGE: 2
OF: 4
EFFECTIVE: 7/10/2006
REVISED:
The team should be activated for the following vital signs:
Infant < 1 year:
Pulse: <80, >200
Systolic Blood Pressure: <60
Respiratory Rate: <12, >80
Oxygen saturation (on O2): <90%
Child 1-10 years:
Pulse: <60, >180
Systolic Blood Pressure: <80
Respiratory Rate: <10, >60
Oxygen saturation (on O2): <90%
Adolescent >10 years:
Pulse: <40, >130
Systolic Blood Pressure: <90
Respiratory Rate: <8, >50
Oxygen saturation (on O2): <90%
Adult:
Pulse: <45, >125
Systolic Blood Pressure: <90
Respiratory Rate: <10, >30
Oxygen saturation (on O2): <90%
PROCEDURE TO ACTIVATE:
The staff member activating will notify the House Supervisor: “I need
to activate the Rapid Response Team”. The staff member will give the patient’s room number
and a very brief reason for the activation. The House Supervisor will notify the other members of
the team and the team will simultaneously report to the room.
D:\106743168.doc
FACILITY:
SUBJECT:
MOUNTAIN VIEW HOSPITAL DISTRICT
RAPID RESPONSE TEAM (RRT)
DEPARTMENT: NURSING
POLICY OWNER: DIRECTOR QUALITY MANAGEMENT
APPROVED BY: S.BEAN RN BSN
REVIEWED:
REFERENCE #
PAGE: 3
OF: 4
EFFECTIVE: 7/10/2006
REVISED:
TEAM PROCESS ONCE ACTIVATED:
The team will use the SBAR guidelines:
SITUATION: Ascertain the concern/problem, when it started, etc.
BACKGROUND: Obtain background information related to the
situation such as: date of admission and diagnosis, current
medications, IV fluids, most recent lab values and previous values for
comparison, most recent vital signs, code status, etc.
ASSESSMENT: Assess the patient, provide team’s assessment of
the situation.
RECOMMENDATION: Provide recommendations*, assist with
interventions and communication with attending MD, educate and
support nurse and patient/family, assist with transfer to ICU or
interhospital transfer.
*The team has established interventions/protocols they can initiate immediately,
before contacting the physician which are:







D:\106743168.doc
ACLS protocols
Nebulizer treatment
ABG
CXR
Labs: CBC, CMP, troponin, or other pertinent
EKG
O2 protocol
FACILITY:
SUBJECT:
MOUNTAIN VIEW HOSPITAL DISTRICT
RAPID RESPONSE TEAM (RRT)
DEPARTMENT: NURSING
POLICY OWNER: DIRECTOR QUALITY MANAGEMENT
APPROVED BY: S.BEAN RN BSN
REVIEWED:
REFERENCE #
PAGE: 4
OF: 4
EFFECTIVE: 7/10/2006
REVISED:
DOCUMENTATION:
The Rapid Response Team forms will be maintained on the crash carts, and can be found
on the N: drive under N:\Nursing\2006 Acute Care Nursing P&P\Rapid Response Team
Forms.doc.
The team will document their assessment, MD response, interventions and patient
response on the Rapid Response Team Record. This will remain part of the medical
record.
The original will be placed in the progress notes section, and a copy will be forwarded to
the Director of Acute Care Nursing Services.
The team will provide non-punitive, non-judgmental feedback to the staff member
activating the team.
EVALUATION OF PROGRAM:
All RRT activations will be reviewed at Acute Care committee, and recommendations
considered by that committee and the organizing committee.
The team, staff and MD’s involved in the activation will be given a chance to provide
feedback on an established form. These will be reviewed by the organizing committee and
recommendations considered.
D:\106743168.doc