Literature review: do rapid response systems reduce the incidence of major adverse events in the deteriorating ward patient?

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Title Literature review: do rapid response systems reduce the incidence of major adverse events in the deteriorating ward patient?
Author Massey, Debbie; Aitken, Leanne Maree; Chaboyer, Wendy
Journal Name Journal of Clinical Nursing
Editor Roger Watson, Debra Jackson, Carol Haigh
Year Published 2010
Place of publication United Kingdom
Publisher Wiley-Blackwell Publishing
Abstract AIMS: To conduct a literature review that explores the impact of rapid response systems on reducing major adverse events experienced by deteriorating ward patients. BACKGROUND: Patients located on hospitals wards are frequently older, have multiple co-morbidities and are often at risk of life-threatening clinical deterioration. Rapid response systems have been developed and implemented to provide appropriate and timely intervention to these patients. DESIGN: A comprehensive review of the literature. METHODS: This review used the rapid response systems framework recently developed by experts in the area. Medline, CINAHL, Embase and Cochrane databases were searched from January 1995-June 2009. Sixteen papers were selected that most clearly reflected the research aim. Each paper was critically appraised and systematically assessed. Major themes and findings were identified for each of the studies. RESULTS: The effectiveness of rapid response systems in reducing major adverse events in deteriorating ward patients remains inconclusive. Six studies demonstrated that the introduction of a rapid response systems positively impacted on patient outcomes, but three studies demonstrated no positive impact on patient outcomes. Nursing staff appear reluctant to use rapid response systems; the rationale for this is unclear. However, the continued underuse and inactivation may be one reason why research findings evaluating rapid response systems have been inconclusive. CONCLUSIONS:   The paper illustrates two important gaps in the literature. First, 'ramp-up' systems have not been subjected to formal evaluation. Second, rapid response systems are under-activated and underused by nursing staff. There is an urgent need to explore the reasons for this and to identify interventions to improve the activation of these systems in an effort to promote safe and effective care to the deteriorating ward patient. RELEVANCE TO CLINICAL PRACTICE: Rapid response systems are multidimensional models. They are relatively new innovations that have important implications for clinical research and implementation policy. This review contributes to the emerging debate on rapid response systems.
Peer Reviewed Yes
Published Yes
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Copyright Statement Copyright 2010 Wiley-Blackwell Publishing. This is the author-manuscript version of the paper. Reproduced in accordance with the copyright policy of the publisher.The definitive version is available at
Volume 19
Issue Number 23-24
Page from 3260
Page to 3273
ISSN 1365-2702
Date Accessioned 2011-01-20
Language en_AU
Research Centre Centre for Health Practice Innovation; Menzies Health Institute Qld
Faculty Griffith Health Faculty
Subject Clinical Nursing: Primary (Preventative); Clinical Nursing: Secondary (Acute Care)
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1

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