Implementing a rapid-response team using a nurse-to-nurse consult approach

The majority of in-hospital cardiac arrests are preceded by observable indicators of deterioration within hours of the event. It is generally accepted that cardiac arrest occurs in response to cardiac arrhythmias, hypotension, and acute respiratory changes. Numerous research studies support that early recognition and prompt treatment of the early indicators of these conditions are associated with improved clinical outcomes and reduced mortality. National initiatives that support the use of emergency medical teams report significant improvement in mortality and morbidity. Health care quality initiatives, such as the 100,000 Lives Campaign and Preventing 5 Million Lives from Harm, advocate the use of rapid response teams in acute care facilities as a method to facilitate early recognition and management of patients at risk for cardiac arrest. One year after the implementation of a rapid response team at our academic tertiary care facility, the incidence of code blue events outside of the intensive care unit was reduced by 9% and overall mortality was reduced by 0.12%. This article will discuss the experience of developing, implementing, and evaluating outcomes associated with a rapid response team using a nurse-to-nurse consult approach.