Rapid response systems and systematic staffing reviews are two nursing strategies that can be used to prevent failure to rescue and maintain patient safety. Foremost, as proven by Subbe and Welch (2013), rapid response systems would allow for healthcare practitioners to conduct high-quality monitoring of vital signs, identify aberrant pathological patterns in routine patient interactions, and escalate any anomalies to a dedicated rapid response team who can respond in a timely manner. (Subbe and Welch, 2013) This would involve the division of the nursing team into two sections: a general care team, and a rapid response team, of which the latter would be exclusively responsible for responding in a swift manner to any escalations of adverse events, in order to prevent failure to rescue.
Rapid response teams may, however, feature significant drawbacks. Foremost, hospitals are often reluctant to specifically assign a team of rapid responders, as it leads to a decline in the nurse staffing ratio, while the team of rapid responders may not be actively deployed to their ful capacity. This is especially significant, given that most hospitals already face insufficient staffing of nurses. Hospital management teams may also regard broad-based training in adverse event identification as sufficient to manage adverse events, given that adverse events and failure to rescue are not seen as sufficiently frequent incidents to warrant the deployment of a special rapid response team. Furthermore, rapid response teams may be more effective in hospitals with higher complication rates, because those hospitals have a suitable environment for training rapid response nurses in recognizing and responding to complications as they develop, while hospitals with lower complication rates typically have less opportunities for nurses to develop symptom identification and rescue skills. (Ghaferi et al, 2009)
Secondly, systematic staffing reviews of training and operations would help to maintain patient safety. Such reviews would allow nurses to streamline communications, conduct resuscitation training, adequately equip themselves with knowledge of pathological symptoms, and implement effective escalation protocols. (Johnston et al, 2015) This would allow nurses to contribute more effectively to the prevention of avoidable harm, by equipping them with sufficient resources, staffing and knowledge to escalate potential failure-to-rescue cases ahead of time and surface them for targeted intervention. (Johnston et al, 2015)
These staffing reviews would also allow for nurses to undergo simulation training in order to close their skill and knowledge gap, which Cooper et al (2011) showed to be successful in eliminating failure to rescue. (Cooper et al, 2011) In particular, Audet et al (2018) conducted a literature review of studies from 1996 to 2017 on the impact of nurse education in an acute care setting on nursing response to adverse events, and found that higher levels of nurse education were associated with lower risks of failure to rescue and mortality in 75% of the reviewed studies. (Audet et al, 2018) This demonstrated that higher nurse education helps to reduce the risks of death from failure to rescue, and that nurses need to be equipped to properly recognize and handle adverse events.
In conducting systematic staffing reviews of training, nurses should also be trained to examine patients for indicative risk factors which may indicate higher incidence of adverse events linked to failure to rescue. For example, a study by McNicol et al (2007) of elderly patients having non-elective, non-cardiac inpatient surgery in one of three Melbourne teaching hospitals showed a 6% 30-day mortality rate and a 19% postoperative complications rate, which were linked to incidence of complications such as underlying age-related conditions, acute renal impairment, underlying systemic disease and albumin levels. (McNicol et al, 2007) Nurses should be trained to assess patients for such risk factors during their in-processing, in order to better manage and identify the onset of adverse events that may lead to failure to rescue.
As part of these systematic staffing reviews, hospital management teams should also consider the use of advanced technologies such as smart monitors equipped with machine learning capabilities. These technologies will augment the in-person interactions of nurses with their patients by detecting minor fluctuations in patient vitals, such as pulse, blood plasma and breathing rate, that can be indicative of more serious complications such as systematic inflammatory response syndrome or sepsis. (Ghaferi et al, 2011) Nurses should also be trained to use and operate these equipment as part of their daily routine.
Worry about your grades?
See how we can help you with our essay writing service.