# “We Don’t Want to Cry Wolf”: A Qualitative Study About Nurses’ Experiences Activating Rapid Response Teams

## TL;DR

This study explores how nurses on general adult inpatient units in Canada decide to activate Rapid Response Teams when patients are deteriorating.

## Contribution

The study provides new insights into the complex decision-making process nurses use to activate RRTs in a Canadian context.

## Key findings

- Nurses face multiple barriers and facilitators when deciding to activate RRTs.
- A self-imposed complexity theme emerged from the decision-making process.
- The study informs future improvements in RRT policies and nursing education.

## Abstract

Patient clinical deterioration is a major safety concern. One strategy implemented for health providers to improve the timely recognition and response to patient deterioration is the Rapid Response Team (RRT). Despite this resource, patient deterioration still occurs and delayed activation of the RRT is one contributing factor. Little is known about unit-level nurses’ experiences related to RRT activation, especially within the Canadian context, which is problematic given they are the ones who are primarily responsible for initiating the process. The purpose of this study was to understand the experiences of nurses practising on general adult inpatient medicine units and their activation of the RRT.

The research question was addressed with a descriptive, exploratory qualitative study. Nurses working on general adult inpatient medicine units at an Ontario hospital study site were purposively recruited to participate. Semi-structured interviews with the six participants were held online and audio-video recorded. Inductive, thematic analysis was used.

Eleven themes about the barriers and facilitators to RRT activation, and one overarching theme—the Self-Imposed Complexity of Deciding to Activate the RRT—resulted in relation to the nuanced, multi-factorial decision-making process unit-level nurses undertake when considering activation.

This study contributes novel information to better understand RRT activation by nurses and will inform practice changes surrounding RRT policies, nursing education about the RRT, and new research on optimizing strategies for RRTs and deteriorating patients. The multi-layered activation process intricacies positions future work to improve escalation of patient clinical deterioration.