Nurses' Perceptions of Rapid Response Teams in Hospitals
This paper reviews the literature on staff nurses' perceptions of Rapid Response Teams (RRTs) in acute care hospital settings. Drawing on studies by Johal (2008), Tee et al. (2008), and reports from the Institute for Healthcare Improvement, the paper examines nurses' attitudes toward RRTs — including concerns about judgment being criticized, enthusiasm for collaborative support, and the cultural shift RRTs produce between ICU and floor nurses. The paper also addresses the challenges of implementing Rapid Response Systems and presents research findings on how RRT exposure influences nurses' individual, group, and organizational learning outcomes related to patient deterioration management.
- Introduction: Overview of RRTs and study significance
- Nurses' Perceptions and Cultural Impact of RRTs: Nurse attitudes, collaboration, and cultural change
- Hospital Outcomes and Data Supporting RRTs: Mortality reductions and outcome statistics
- Challenges of Implementing Rapid Response Systems: Political, cultural, and logistical barriers to RRS
- Staff Nurses' Learning Outcomes and Research Findings: Johal study hypotheses and empirical results
- Summary and Conclusion: Synthesis of perceptions and overall RRT acceptance
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What makes this paper effective
- It synthesizes multiple primary sources — including nurse testimonials, institutional data, and peer-reviewed studies — to build a nuanced picture of RRT perceptions from multiple angles.
- The use of direct quotations from practicing nurses grounds the academic argument in real clinical experience, making abstract concepts tangible.
- Quantitative outcomes (e.g., 44% decrease in cardiac arrests, 16% reduction in mortality) are integrated alongside qualitative evidence to reinforce the case for RRTs.
Key academic technique demonstrated
The paper demonstrates effective literature synthesis: rather than summarizing each source in isolation, it weaves together findings from practitioner reports, institutional data, and nursing research to develop a coherent argument about how RRT adoption changes nursing culture and outcomes. Hypothesis testing from Johal (2008) is reported with appropriate statistical detail, showing how to incorporate empirical research findings into a review paper.
Structure breakdown
The paper opens with context on RRT significance and then dedicates its largest section to nurse perceptions and cultural impact, drawing heavily on IHI reports and nurse testimonials. It then pivots to outcome data and implementation challenges before presenting Johal's (2008) empirical study findings in detail. The conclusion synthesizes all threads, acknowledging both positive perceptions and remaining hesitancies. This structure — context, perceptions, evidence, research, synthesis — is a sound model for a literature-based review paper.
Introduction
Rapid Response Teams (RRTs) are critically important in hospital settings to reduce the failure to resuscitate patients. However, questions remain about nurses' perceptions of RRTs and what those perceptions mean for team adoption and effectiveness. The significance of this review lies in the knowledge it contributes to the existing body of literature on staff nurses' perceptions of RRTs.
Nurses' Perceptions and Cultural Impact of RRTs
Heintz and Schreiner (2007), in their work "Improving Patient Safety Through the Use of Rapid Response Teams," note that staff nurses "may be fearful that RRT members will criticize their clinical judgment." In contrast, the Institute for Healthcare Improvement (IHI) reports that many hospital nurses welcome the idea of a Rapid Response Team. Beyond their clinical value, RRTs are changing hospital culture: "Nurses are encouraged and empowered to ask for help without fear of appearing incompetent, there's more emphasis on shared learning, and everyone gets the message that support is a critical component in clinically challenging situations. All these benefits are expected to have a positive impact on nursing recruitment, retention, and satisfaction." (Institute for Healthcare Improvement, 2010)
Long-time nurses observe that the Rapid Response Team concept "draws on the kind of collaboration that has always been part of the profession, but that has been harder to maintain as nurses have gotten busier with more and sicker patients." (Institute for Healthcare Improvement, 2010) One nurse, Mary Therriault, RN, reflected:
"When I began in nursing, I was surrounded by people with different levels of education and experience, and I would always ask someone to give me their opinion about things like a patient's color or mental status… It felt like team care, and I think we got away from that. This brings back the team concept." (Institute for Healthcare Improvement, 2010)
The RRT concept has also become a recruitment draw. Some new nurses report that they considered jobs only at hospitals that have Rapid Response Teams. One new nurse said that among her greatest fears was working the night shift "and having no one to go to if a patient's condition changes." (Institute for Healthcare Improvement, 2010) The nursing program chair at Richmond Heights Hospital noted that the somewhat older average student — around 32 years old — "often bring well developed critical thinking skills and many have gained self-confidence in another career and aren't afraid to ask for help. They aren't insecure and worried about appearing inadequate." (Institute for Healthcare Improvement, 2010)
Faculty expert Kathy Duncan observed that excitement about RRTs is spreading throughout the nursing community: "The appeal of the Rapid Response Team is that nurses don't have to go it alone anymore. It means they don't have to feel alone when they have an inkling that something might be wrong. It means they can get a colleague or several to validate their concerns or put them to rest." (Institute for Healthcare Improvement, 2010)
Duncan also linked RRT support to nurse retention, noting that frustration and fear of making mistakes may explain why a 2001 report published in Health Affairs found that about a third of nurses under the age of 30 reported plans to leave their hospital nursing jobs within a year. She added that one of her nurses told the Chief Nursing Officer "that the Rapid Response Team is one of the best things she's ever done for nursing and for patients." (Institute for Healthcare Improvement, 2010)
Barbara Rogness at St. Joseph's in Milwaukee collected the following representative comments when evaluating Rapid Response Team calls:
"This was a great experience, with great ideas put into place quickly."
"The team asked for my needs, and then together we dealt with the patient's needs."
"Several suggestions made the patient outcome improve."
"Although this patient's assessment was unremarkable, the x-ray the team ordered was instrumental in diagnosing his worsening heart failure." (Institute for Healthcare Improvement, 2010)
Duncan reported hearing similar comments from hospitals across the United States: "What nurses are discovering is that this is not just a tool to rescue patients. It's a tool to help colleagues support one another. The more I see it in practice and the more I study it, the more convinced I am that this represents a dramatic change in the culture of nursing, and an exceptionally good teaching tool. What a new nurse can learn on one Rapid Response call will help her and her patients for the next 20 years." (Institute for Healthcare Improvement, 2010)
Hospital Outcomes and Data Supporting RRTs
According to Cathy Pfeil, RN, BSN, CCRN, Director of Critical Care Nursing at Tallahassee Memorial Hospital — a VHA-member hospital that has had Rapid Response Teams in place since 2003 — data confirms the nurses' positive perceptions: in less than two years, the hospital saw a 16% reduction in mortality and a 72% reduction in codes outside the ICU. (Institute for Healthcare Improvement, 2010)
This kind of collaboration in patient care "has helped bridge an age-old cultural divide between ICU nurses and floor nurses." (Institute for Healthcare Improvement, 2010) Lisa Leach, LPN, an ICU nurse at UHHS Richmond Heights Hospital who serves on her hospital's Rapid Response Team, described the change:
"There's always been a little bit of tension between the two, but with the Rapid Response Team, the ICU nurses get a better understanding of what the floor nurses are dealing with. We care for two critically ill patients in the ICU; they have a demanding patient load and it is spread throughout the floor… the floor nurses grow to respect the expertise of their ICU colleagues, and begin to learn from them. Now the nurses are better prepared when we get there. They are part of our team." (Institute for Healthcare Improvement, 2010)
Leach further noted that floor nurses will sometimes come to the ICU to check on patients transferred there following an RRT call — a practice that would not have occurred before. "Now those barriers have been broken down." (Institute for Healthcare Improvement, 2010)
Sharon Garretson of Richmond Heights Hospital reported that initial resistance gave way to strong support: "If we said today we were going to get rid of the Rapid Response Team, we'd probably have a mutiny on our hands. Part of the key to that attitude change is data showing the impact of the Team." (Institute for Healthcare Improvement, 2010) Mary Beth Rauzi, RN, MSN, Manager of Learning Services at Richmond Heights, added: "We have decreased cardiac arrests per 1,000 discharges by 44%, and cardiac arrests outside the ICU by 67%. Our total mortality is down 14%. When nurses see results like that, they see that they are making good calls, their judgment is being validated, and they are proud to be part of this change." (Institute for Healthcare Improvement, 2010)
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