Madison Tilley is an RN at St. Mary Mercy Livonia Hospital, Livonia, MI, and Kathleen Spencer is a special instructor at Oakland University School of Nursing, Rochester, MI. Contact author: Madison Tilley,
Am J Nurs. 2020 Jul;120(7):52-60. doi: 10.1097/01.NAJ.0000688220.05900.7c.
The purpose of this literature review was to investigate the major barriers nurses face when it is necessary to seek additional assistance and resources by calling the rapid response team (RRT) in order to manage and stabilize a clinically deteriorating patient. A total of 40 articles were reviewed. Eight barriers were identified as having an impact on RRT activation, either causing a delay in activation time or preventing activation altogether: a lack of consistent RRT education among nurses, the established hierarchy in the hospital, an uncertainty about when to call the RRT if clinical deterioration is subtle or gradual rather than abrupt, a perceived need to justify a decision to call the RRT, the increased workload for both the ICU nurse and the medical-surgical nurse, negative past experiences with RRTs, an unsupportive unit culture, and less nursing experience. Suggestions for overcoming these barriers include RRT education for nurses and physicians in addition to fostering a supportive unit culture.
本次文献回顾的目的是研究护士在需要通过呼叫快速反应团队(RRT)来寻求额外的帮助和资源以管理和稳定病情恶化的患者时所面临的主要障碍。总共回顾了 40 篇文章。确定了 8 个对 RRT 激活有影响的障碍,这些障碍要么导致激活时间延迟,要么完全阻止激活:护士之间缺乏一致的 RRT 教育、医院内部的既定等级制度、如果病情恶化不明显或逐渐而不是突然,不确定何时呼叫 RRT、认为有必要为呼叫 RRT 做出决定、ICU 护士和普通外科护士的工作量增加、对 RRT 的负面过往经验、不支持的单位文化以及较少的护理经验。克服这些障碍的建议包括对护士和医生进行 RRT 教育,以及培养支持性的单位文化。