Barriers to Rapid Response Team Activation among Nurses and Residents in a Brazilian Teaching Hospital

Abstract

Background: The afferent limb of a Rapid Response System (RRS) may fail to identify deteriorating patients and activate the efferent limb.
Aims: To identify and evaluate barriers to RRT activation in a Brazilian teaching hospital.
Methods: An anonymous Likert-type survey was applied. Data were collected between July and November 2024. The Index of Agreement (IA) was calculated for each item, and IA between residents and nurses was compared using the chi-square test.
Results: Of 344 residents and 71 nurses invited, 174 residents (50.6%) and 37 nurses (52.1%) participated. Most respondents (86%) agreed that the RRT can manage clinically deteriorating patients. Additionally, 78% of residents and 89% of nurses agreed that the RRT helps prevent cardiac arrest. A large proportion (85% of residents and 100% of nurses) reported they would contact the assistant team before activating the RRT. However, 79% of residents and 86% of nurses would call the RRT if unable to reach the assistant team. Most respondents (80%) disagreed that they fear activating the RRT. Furthermore, 78% of residents and 62% of nurses disagreed that RRT calls result from inadequate physician care. Finally, 75% of residents and 86% of nurses agreed that the RRT contributes to learning how to manage deteriorating patients.
Conclusion: Residents and nurses perceive the RRT as valuable for preventing clinical deterioration and as an important educational resource. Although they do not fear activation, most staff report a tendency to contact the assistant team before calling the RRT.

Keywords: rapid response team, afferent limb failure, nurses, residents, deteriorating patient.