Date of Conferral
Doctor of Nursing Practice (DNP)
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.