System Barriers to RN Activation of Rapid Response Teams: New Evidence

By Sylvia Foley, AJN senior editor

Rapid response teams (RRTs) in acute care facilities are there to decrease mortality from preventable complications. But there is evidence that RRT systems “aren’t working as designed, particularly with regard to problems in the activation stage,” according to nurse researcher Jane Saucedo Braaten.

Figure 1. Five Domains of Cognitive Work Analysis and Corresponding Study Questions Figure 1. Five Domains of Cognitive Work Analysis and Corresponding Study Questions (click image to enlarge)

Interested in how hospital system factors influence RNs’ activation behavior, Braaten decided to investigate further. She reports on her findings in this month’s CE–Original Research feature, “Hospital System Barriers to Rapid Response Team Activation: A Cognitive Work Analysis.” Here’s a summary.

Purpose: To use cognitive work analysis to describe factors within the hospital system that shape medical–surgical nurses’ RRT activation behavior.
Methods: Cognitive work analysis offers a framework for the study of complex sociotechnical systems and was used as the organizing element of the study. Data were obtained from interviews with 12 medical–surgical nurses and document review.
Results: Many system factors affected participants’ activation decisions. Systemic constraints, especially in cases of subtle or gradual clinical changes, included a lack of adequate information, the availability of multiple strategies, the need to justify RRT activation, a scarcity of human resources, and informal hierarchical norms in the […]

2017-07-27T14:42:21-04:00February 6th, 2015|nursing perspective, nursing research|1 Comment
Read More

Enough Rants: On Fostering Meaningful Dialogue

Karen Roush PhD, RN, is an assistant professor of nursing at Lehman College in the Bronx, New York, and founder of the Scholar’s Voice, which works to strengthen the voice of nursing through writing mentorship for nurses.

Angry woman, Ranting By Amancay Maahs/Flickr

“Patients are never satisfied!” “Only bedside nurses really understand nursing!” “Management always takes advantage of you!”

These are examples of the types of statements I’ve heard recently, whether talking with other nurses or reading blogs or other social media. Often presented as contributions to discussion, in reality they are rants—more interested in eliciting rote agreement than in true dialogue. This has got me thinking about how we create dialogue, especially about topics that stir an emotional response—particularly when anger is front and center. I’m a firm believer that:

  • creating dialogue is necessary and transformative
  • strong emotions are often the impetus for needed change

But we can’t allow emotions to dominate. When they do, our discussion is no longer a dialogue; it’s a rant. And rants are not productive for creating change. They eat up the energy that could otherwise be directed to positive action.

So, how do we do create dialogue about the issues that get our backs up? Here are my thoughts:

2016-11-21T13:03:05-05:00February 4th, 2015|healthcare social media, Nursing, nursing perspective|4 Comments
Read More

So You’re a Nurse With a Story to Tell…

Madeleine Mysko, MA, RN, coordinator of AJN’s monthly Reflections column, is a poet, novelist, and graduate of the Johns Hopkins Writing Seminars who has taught creative writing in Baltimore for many years.

karindalziel/ via Flickr Creative Commons karindalziel/ via Flickr Creative Commons

Whenever I meet someone new who happens to be a nurse—in both clinical and social settings—I wait for the right moment to mention my work at AJN on the Reflections column. It’s not only that I’m proud of the column. It’s also that I’m forever on the lookout for that next submission—for a fresh, compelling story I just know is destined to shine (accompanied by a fabulous professional illustration) on the inside back page of AJN.

“I imagine you have a story or two to tell,” I’ll say to a nurse I’ve just met—which is the same thing I say, whenever I have the chance, to nurses I’ve known for years. I mean it sincerely; given the vantage point on humanity that our profession affords, I actually do believe that every nurse is carrying around material for a terrific story.

The response I usually get (along with a wry smile, the raising of eyebrows, or a short laugh) is, “Oh yes. I have stories.”

But then—even as I’m mentioning the Reflections author guidelines, even as […]

2018-04-17T13:41:27-04:00January 30th, 2015|narratives, Nursing, nursing perspective, nursing stories|5 Comments
Read More

AJN in February: Rapid Response Teams, Complications of CHD Repair, Managing Type 2 Diabetes, More

AJN0215 Cover OnlineAJN’s February issue is now available on our Web site. Here’s a selection of what not to miss.

Rapid response teams (RRTs) are teams of expert providers who can be called on in an emergency to treat patients before their condition deteriorates. The success of an RRT depends on whether it is activated properly, a task that often falls to staff nurses. The original research article, “Hospital System Barriers to Rapid Response Team Activation: A Cognitive Work Analysis,” describes the factors affecting nurses’ decisions to activate RRTs. This CE feature offers 3 CE credits to those who take the test that follows the article.

Further explore this topic by listening to a podcast interview with the author (this and other free podcasts are accessible via the Behind the Article podcasts page on our Web site, in our iPad app, or on iTunes).

Long-term complications after congenital heart defect (CHD) repair. Nurses often encounter patients with complications that occurred years after CHD repair. “Long-Term Outcomes After Repair of Congenital Heart Disease: Part 2” reviews four common CHDs, their repairs, common long-term outcomes, and implications for nurses in both cardiac and noncardiac settings. This article offers 2.5 CE credits to those who take the test that follows the article.

Making nurses full partners in reforming health care. The Institute of Medicine’s report, The […]

2016-11-21T13:03:07-05:00January 29th, 2015|career, Nursing, nursing perspective|0 Comments
Read More

Ebola Still Deserves Our Attention

By Shawn Kennedy, AJN editor-in-chief

Photographed by Centers for Disease Control and Prevention’s (CDC) team member, and EIS Officer, Dr. Heidi Soeters during Guinea’s 2014 Ebola outbreak, this image depicts what resembled a garden of red- and green-colored gloves propped up on sticks in order to dry after having been washed in a hyperchlorinated solution, thereby, killing any live Ebola viral particles. The pink-colored gloves were merely inside-out red gloves with their interiors exposed. The image was captured on the grounds of Donka Hospital, located in the country's capital city of Conakry/CDC Taken by Dr. Heidi Soeters during Guinea’s 2014 Ebola outbreak, photo depicts red- and green-colored gloves propped on sticks to dry after being washed in a hyperchlorinated solution./CDC

It’s sad but not surprising that Ebola has all but disappeared from the headlines. After all, it’s not an imminent threat here anymore. There’s […]

2016-11-21T13:03:08-05:00January 26th, 2015|infectious diseases, Nursing|1 Comment
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
Go to Top