Purpose:

The purpose of this project is 2-fold-first, to improve patient outcomes by development and implementation of a rapid response team at a Northwest Arkansas regional hospital, and second, this prototype project is being used to help establish the clinical nurse specialist (CNS) role in a hospital that previously has not used CNSs.

Significance:

Rapid response teams have been shown to decrease cardiac arrest and mortality rates. Research further shows that most critical events are preceded by warning signs for an average of 6.5 hours.

Background/Design:

The CNS students function as change agents; therefore, we used change theory in development and implementation of the team.

Methods:

This project took place in a 250-bed regional hospital facility in Northwest Arkansas. The development team started with 2 CNS students and the vice president of Medical Affairs. Meetings were held by the development team for 6 months, with protocols and plan of implementation developed. Protocol development was completed using other established protocols from rapid response teams in the United States and other published sources such as the Institute for Healthcare Improvement: Getting Started Kit for Rapid Response Teams.

Findings:

Outcome measurements are also 2-fold. First, the proposed outcomes for measurement from the rapid response team implementation are patient quality indicators that include cardiac arrest avoidance rates and cardiac arrest survival rates when the rapid response team was initiated. Physician and nursing staff satisfaction will also be measured to determine the effectiveness of collaborative care. Nurse retention rates will also be compared pre- and post-team implementation. Initial outcomes measurements will be completed in January 2007.

Conclusions:

This student project is still ongoing. Initial patient quality indicators outcomes measurements are positive. Final outcome measurement for the second goal of the project will be an employment opportunity for the CNS program graduate within the facility.

Implications for Practice:

First, the implication for practice is the impact that this student project has had on patient outcomes in this Northwest Arkansas facility. Second, is the implication of showing the worth of the CNS role to the leadership of the facility.