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Introduction
Evidence-based practice (EBP) is a problem-solving strategy for care delivery that incorporates the most current scientific data with the patient’s preferences and principles and the clinician’s knowledge and skills. Best available research evidence, patient preferences, clinical knowledge, and awareness of clinical constraints are the four pillars of EBP. The scientific understanding that underpins the EBP is the best available research evidence. It is critical to remember that the best research evidence pertains to the specific question and is not always the most recent or frequently cited (Gallagher‐Ford et al., 2020). In EBP, patient preferences are crucial because nurses must consider the patient’s culture and concerns when providing care. Hence, it enables the best clinical judgments, benefitting patient outcomes.
Clinical expertise is the nurses’ judgment and expertise that benefits their patients the most. Thus, to make clinical decisions specific to each patient’s needs, nurses draw on their expertise and experience. Clinical restraints are understood concerning the staffing, financial support, supplies, equipment, and technology required to implement EBP. When implementing EBP, these limitations must be considered to guarantee that the best results can be obtained with available resources (Gallagher‐Ford et al., 2020). As a result, this paper introduces higher acuity levels – a problem during the Covid-19 outbreak in the neurological unit at Neuromedical Center, a previous work setting.
Problem statement
The neurological unit at Neuromedical Center dealt with patients with higher acuity levels during the COVID-19 pandemic. More cardiac arrests, strokes, respiratory failure, and aspiration incidents in the previous six months necessitated a transfer to another hospital; three patients died during this period. It is now standard practice for staff nurses to dial 911 when a patient is deteriorating or coding. This option is not always sufficient to prevent emergencies and patient deaths. As a result, early intervention was required to address this issue.
One potential solution is to establish a rapid response team (RRT) led by nurses with specialized knowledge. Lancaster et al. (2020) found that using RRTs significantly reduced the number of in-hospital cardiac arrests and unexpected hospital admissions. This premise is consistent with the fundamental principle of evidence-based practice (EBP), which emphasizes the significance of choosing the best research evidence that is currently available and incorporating it with clinical decisions.
The problem statement is: How might a nurse-led rapid response team at the facility prevent and enhance patient outcomes compared to not having one? People who have had strokes, traumatic brain injuries, spinal cord injuries, neurological diseases, amputations, and orthopedic incidents and require rehabilitation to enhance their quality of life make up the patient population at the institution. The proposed intervention compares the impact of having a nurse-led rapid response team versus not having one on the quantity of declining patients who experience emergencies like cardiac arrest, respiratory failure, or aspiration throughout three months (Lancaster et al., 2020). Therefore, by implementing RRTs, it may be possible to lower patient mortality, prevent emergencies, and enhance patient outcomes.
EBP question
This study aims to determine whether implementing a nurse-led rapid response team (RRT) at the neurological unit at Neuromedical Center can potentially prevent and improve patient outcomes compared to not having an RRT. Patients with stroke, traumatic brain injury (TBI), spinal cord injury, neurological disease, amputation, and orthopedic injuries who require rehabilitation to enhance their quality of life make up the patient population of this study. The number of declining patients who experience emergencies over three months, such as cardiac arrest, respiratory failure, or aspiration, may be decreased by implementing an RRT (Ashbeck et al., 2020). This study will compare the impact of having a nurse-led RRT versus not having one on the number of patients going through these emergencies.
Rapid response teams (RRTs) are an effective intervention for reducing rates of in-hospital cardiac arrest and unanticipated hospital admissions. According to Ashbeck et al. (2020), 6 to 8 hours before a cardiac arrest, up to 84% of patients exhibit clinical deterioration. Failures in planning, such as insufficient treatment or assessment, a breakdown in staff communication, or a failure to spot early or subtle signs of the patient’s deterioration, could all lead to the failure to rescue. Hence, by providing early intervention for deteriorating patients, RRT implementation can assist in resolving these problems. Nurses frequently lead RRTs with specialized knowledge, such as advanced training in critical care, who can assess and triage patients quickly. Besides, RRT offers interdisciplinary collaboration and communication opportunities, which can enhance patient outcomes.
Using RRTs decreased cardiac arrest and unscheduled ICU admissions by a statistically significant amount (Ashbeck et al., 2020). Another study found that RRTs were linked to a decline in overall hospital mortality rates (Lancaster et al., 2020). Additionally, RRTs can lessen the workload in caring for critically ill patients while also enhancing staff confidence and abilities in managing deteriorating patients. RRTs are thought to improve patient safety by giving patients the proper level of care during times of crisis and avoiding complications and patient trauma (Lancaster et al., 2020).
Conclusion
In conclusion, it has been demonstrated that implementing RRTs improves patient outcomes, staff confidence, and skills and lowers rates of in-hospital cardiac arrest and unanticipated hospital admissions. It offers interdisciplinary collaboration and communication opportunities, which can enhance patient outcomes. RRT use is a promising strategy to improve hospital care delivery and increase patient safety.
References
Ashbeck, R., Stellpflug, C., Ihrke, E., Marsh, S., Fraune, M., Brummel, A., & Holst, C. (2020). Development of a standardized system to detect and treat early patient deterioration. Journal of Nursing Care Quality, 36(1), 32–37. Web.
Gallagher‐Ford, L., Koshy Thomas, B., Connor, L., Sinnott, L. T., & Melnyk, B. M. (2020). The effects of an intensive evidence‐based practice educational and Skills Building Program on EBP competency and attributes. Worldviews on Evidence-Based Nursing, 17(1), 71–81. Web.
Lancaster, E. M., Sosa, J. A., Sammann, A., Pierce, L., Shen, W., Conte, M. C., & Wick, E. C. (2020). Rapid response of an academic surgical department to the COVID-19 pandemic: Implications for patients, surgeons, and the community. Journal of the American College of Surgeons, 230(6), 1064–1073. Web.
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