Date of Conferral



Doctor of Nursing Practice (DNP)




Barbara Niedz


Timely activation of the rapid response team (RRT) depends on the nurse's willingness

and ability to make a rapid decision. The practice-focused questions for this DNP project

sought to identify barriers that contribute to delays in activating the RRT when needed in

medical-surgical patients. The self-efficacy theory was the guiding theory and was used

to examine self-confidence and performance along with Donabedian's health care model.

Qualitative data were obtained through focus groups and identified 2 prominent thematic

barriers among nurses with less than 3 years' experience: a lack of self-confidence and

the of lack of knowledge and experience. Results of a chart review included 34 charts to

determine if the RRT were called appropriately and were inconclusive. Finally, an 11

item survey with 9 demographic questions showed a statistically significant difference on

the summed survey score between nurses with less than 3 years of experience and more

tenured nurses, indicating a lack of perceived support, self-confidence, and knowledge

among the nurses with less than 3 years of experience (Pearson chi square = 7.403 with 2

df and p = .025). Results were presented to leaders at the site and the recommendations

resulting from these observations include the use of high-fidelity simulation education.

Nurse educators and senior leadership from the medical surgical units agreed to accept

the recommendations and proceed with developing an educational solution to address the

barriers. Building knowledge, skills and self-confidence in nurses reduces the barriers to

effective use of the RRT, and results in better outcomes for hospitalized medical-surgical

patients, a positive social change.

Included in

Nursing Commons