Rapid Response and COVID19: The CNS Influencer
Topic of Interest
Role of CNS in COVID-19 Pandemic
Abstract
Background
A Rapid Response System (RRS) is defined as a whole system that provides a safety net for patients who suddenly become critically ill and have a mismatch of needs and resources.
Purpose
To describe the role of a 24/7 proactive Rapid Response Nurse (RRN) and Rapid Response Respiratory Therapist (RRRT) team during the COVID19 crisis.
Methods
In 2017, an innovative 24/7 proactive RRN program was implemented to reduce clinical deterioration and cardiac arrest outside ICU. After implementation, a 60% reduction in cardiac arrests outside ICU was seen. In 2019, a RRRT was added to the team after cardiac arrest reviews showed that clinical deterioration was often due to respiratory pathology. In March 2020, this care model supported high acuity COVID19 patients on inpatient floors though high-risk screening, proactive rounding, and early intervention with non-invasive ventilation and high flow oxygen delivery on inpatient floors.
Results
2019 average monthly RRN activity was compared with RRN activity for March 2020, the COVID19 crisis. There was an increase in high risk screening (97%), RN consults (375%), Rapid Responses (22%), intubations (220%) and transfers to ICU (83%). During the same time period, the number of COVID19 positive patients went from zero to 340 and the number of ventilated patients went from 27 to 121. RRN activity validates the ability of the proactive team to flex capacity to meet the COVID 19 patient surge. RN consults demonstrate that floor nurses felt comfortable calling for help from the team. These experts in the field provided clinical support for nurses and patients during the COVID19 crisis.