32 AACN Advanced Critical Care Volume 23, Number 1, pp.32-42 © 2012, AACN Copyright © 2012 American Association of Critical-Care Nurses. Unauthorized reproduction of this article is prohibited. Evaluating a New Rapid Response Team NP-Led Versus Intensivist-Led Comparisons Kimberly Scherr, RN, MN, NP Donna M. Wilson, RN, PhD Joan Wagner, RN, PhD Maureen Haughian, RN, BScN Kimberly Scherr is Nurse Practitioner, Misericordia Hospital, 2E-83 16940-87th Ave, Edmonton, AB T5R 4H5, Canada (kim.scherr@covenanthealth.ca). Donna M. Wilson is Professor, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. Joan Wagner is Assistant Professor, Faculty of Nursing, University of Regina, Regina, Saskatchewan, Canada. Maureen Haughian is Patient Care Manager, Cardiac Services and Critical Care, Grey Nuns Community Hospital, Edmonton, Alberta, Canada. DOI: 10.1097/NCI.0b013e318240e2f9 S erious complications are common among hospitalized patients, as people who are cur- rently admitted to a hospital are at a much higher acuity than in the past, and they often arrive with multiple comorbidities that confound care. Despite staff-mix changes that have reduced the number of registered nurses (RNs) in hospitals, sicker patients can be found on most hospital wards rather than in intensive care units (ICUs), where there is a higher ratio of RNs to patients. Around 60% of deaths in Canada take place in hospitals, with some deaths expected among very elderly patients and those with severe illnesses, but other deaths are potentially preventable. 1 Timely attention to patients who begin to deteri- orate on hospital wards is becoming increasingly important in preventing illness progression and premature death and in preventing last-minute reactive care that results in unplanned ICU admissions and extended hospital stays. In an attempt to reduce morbidity and mor- tality among hospitalized patients, the Ameri- can Institute for Healthcare Improvement introduced its “Save 100 000 Lives” campaign in 2004 across the United States and subse- quently launched the initiative “Protecting 5 Million Lives From Harm” to advocate for the use of rapid response teams (RRTs). 2 Rapid response teams (or medical emergency teams as ABSTRACT Evidence is needed to validate rapid response teams (RRTs), including those led by nurse practitioners (NPs). A descriptive-comparative mixed-methods study was undertaken to evaluate a newly implemented NP-led RRT at 2 Canadian hospitals. On the basis of data gathered on 255 patients who received an RRT call compared with the patient data for the previous year, no significant differences in the number of cardiorespiratory arrests, unplanned intensive care unit admissions, and hospital mortality were found. In addition, no significant differences in patient outcomes were identified between the NP-led and intensivist physician-led RRT calls. A paper survey revealed that ward nurses had confidence in the knowledge and skills of the NP-led RRT and believed that patient outcomes were improved as a result of their RRT call. These findings indicate that NP-led RRTs are a safe and effective alternative to intensivist-led teams, but more research is needed to demonstrate that RRTs improve hospital care quality and patient outcomes. Keywords: clinical crisis, early intervention, evaluation research, nurse practitioner, rapid response team