Last year, the nursing team at Penn Presbyterian Medical Center recognized that our critical care nurses, clinical nurse specialists, and clinical nurse educators were frequently pulled away from their assignments to address emergency situations as our patient volume, acuity, and case complexity grew. This system was not optimal for patient outcomes or staff satisfaction, so we went back to the drawing board. The solution: developing a new, dedicated rapid response/code (RRT/Code) nursing role.
Nurses in the critical care resource pool rotate through the RRT/Code role so there is someone available every day, for every shift, to respond to emergencies. The rotation setup ensures that all of the participating nurses can maintain both critical care and bedside skills while also ensuring 24/7 coverage.
Carrying an easily identifiable orange backpack, the RRT/Code nurse rounds on each unit throughout their shift and serves as a valuable resource for both patients and nurses. Their exceptional clinical skills, dynamic critical thinking, and excellent communication skills all play a vital role in quickly assessing a patient. They regularly provide early, lifesaving interventions before issues escalate to a rapid response event and a patient’s condition worsens. They also check on patients who are transferred out of the intensive care unit to ensure they transition safely and don’t bounce back to the ICU. Other frequent responsibilities have included starting IVs for patients whose veins are difficult to insert a needle into, monitoring and stabilizing high-risk patients, and providing clinical education to their colleagues.
The response to these additional resources has been overwhelmingly positive from all of our clinical staff, as well as patients. By developing a creative solution and implementing this thoughtful workflow adjustment, the nursing team was able to ensure patients receive the best care possible as quickly as possible, while also allowing our critical care nurses to find balance and support.