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patients who are exhibiting early signs of decompensation to prevent further deterioration that could lead to cardiac or respiratory arrest. What is Failure to Rescue? These three problems often lead to failure to rescue a patient in a timely manner: 1. Failure to recognize a problem 2. Failure to appropriately communicate the problem (Patient-to-staff, staff-to-staff, staff-to-physician, etc.) 3. Failures in planning and the ability to treat the problem What difference can an RRN team make? • Published statistics: 50% reduction in non-ICU arrest (Buist,BMJ 02) 44% reduction in Post-Op emergency ICU transfers and deaths by 37% Reduction in arrest prior to ICU transfer (4% versus 30%) Who Can Call The Rapid Response Nurse? • Anyone may initiate the RRN including but not limited to the RN, nurse assistant, radiology personnel, respiratory therapy, physicians, physician assistants, nurse practitioners, families, visitors, and patients based on the developed criteria. • Families and visitors may call the Rapid Response Nurse • Dial extension 7410 Response is expected within five (5) minutes of the call. If there is no response, please call the ADMINISTRATIVE Nursing Supervisor at x8445. If still no response, call the operator and have the RRN paged overhead. When Should I Call the RRN? • Inadequate response to previous intervention/treatment • Altered LOC • O2 sat <90% • RR ><8 or >28 • SBP <90 or >180 • Fio2 demands >50% • Patient complains of chest pain • Uncontrolled or excessive bleeding • New, repeated or prolonged seizures • Sudden onset of unexplained Diaphoresis. • HR <45 or >120 or change of 20 above baseline • New dysrhythmia onset in which RN feels uncomfortable • Acute decline in Urine Output • Urine Output GENERAL PREAMBLE: The purpose of the Rapid Response System (RRS) is to assist in the early recognition of patients at risk of developing critical illnesses. It is well known that greater than 80% of in-hospital cardiac arrests are preceded by a period of abnormal vital signs. There is evidence that 41% of Critical Care Unit admissions may be avoidable if care is provided within this deterioration period. Therefore, the expected results of the RRS is to improve patient outcomes and safety, by quickly identifying patients at risk of becoming critically ill and decreasing the number of in-hospital cardiac arrests. The RRS will be specially trained group of individuals who apply clinical medical directives when a patient’s condition appears to be deteriorating. The RRS will provide additional monitoring as needed and will determine if additional levels of care and treatment are required. If the patient needs to be transferred to Critical Care, the RRS will assist with this and will communicate with the Rapid Response System Physician and / or Most Responsible Physician (MRP). AUTHORIZING PHYSICIANS: These Medical Directives are applicable to the Lakeridge Health. The Authorizing Physicians are all Physicians at Lakeridge Health. “Appropriately Educated Registered Respiratory Therapists (RRT) and Registered Nurses (RN) Responders” will refer to those employees of Lakeridge Health who have successfully attained certification by a course of self-study supplied by the Intensivist – Educators appointed by the Authorizing Physicians, participated in a Didactic and Simulation Day, completed orientation with an established Critical Care Response Team, and have successfully passed both oral and written examinations. The content of the Educational package will be approved by the Medical Department - Critical Care. The Authorizing Physicians expect that only appropriately educated RRTs and RNs; who are employees of Lakeridge Health: with the specific professional qualifications as outlined in each medical directive will implement these medical directives. The Authorizing Physicians also expect that the responders performing the medical directives will adhere to the specific clinical MEDICAL DIRECTIVE Rapid Response System (RRS) – Respiratory Distress Approved by/Date: February 26, 2013 (For LHB Pilot Only) Lakeridge Health Page 2 of 9 conditions/circumstances and contraindications. Deviation from these medical directives is not permitted. The Authorizing Physicians expect that the appointed