Abstract：
BACKGROUND: Outcomes associated with rapid response teams (RRTs) are inconsistent. This may be due to underlying facilitators and barriers to RRT activation that are affected by team leaders and health systems.
OBJECTIVE: The aim of this study was to synthesize the published research about facilitators and barriers to nurse-led RRT activation in the United States (U.S.).
METHODS: A systematic review was conducted. Four databases were searched from January 2000 to June 2023 for peer-reviewed quantitative, qualitative, and mixed methods studies reporting facilitators and barriers to RRT activation. Studies conducted outside the U.S. or with physician-led teams were excluded.
RESULTS: Twenty-five studies met criteria representing 240,140 participants that included clinicians and hospitalized adults. Three domains of facilitators and barriers to RRT activation were identified: (1) hospital infrastructure, (2) clinician culture, and (3) nurses\' beliefs, attributes, and knowledge. Categories were identified within each domain. The categories of perceived benefits and positive beliefs about RRTs, knowing when to activate the RRT, and hospital-wide policies and practices most facilitated activation, whereas the categories of negative perceptions and concerns about RRTs and uncertainties surrounding RRT activation were the dominant barriers.
CONCLUSIONS: Facilitators and barriers to RRT activation were interrelated. Some facilitators like hospital leader and physician support of RRTs became barriers when absent. Intradisciplinary communication and collaboration between nurses can positively and negatively impact RRT activation. The expertise of RRT nurses should be further studied.
OBJECTIVE: The aim of this study was to synthesize the published research about facilitators and barriers to nurse-led RRT activation in the United States (U.S.).
METHODS: A systematic review was conducted. Four databases were searched from January 2000 to June 2023 for peer-reviewed quantitative, qualitative, and mixed methods studies reporting facilitators and barriers to RRT activation. Studies conducted outside the U.S. or with physician-led teams were excluded.
RESULTS: Twenty-five studies met criteria representing 240,140 participants that included clinicians and hospitalized adults. Three domains of facilitators and barriers to RRT activation were identified: (1) hospital infrastructure, (2) clinician culture, and (3) nurses\' beliefs, attributes, and knowledge. Categories were identified within each domain. The categories of perceived benefits and positive beliefs about RRTs, knowing when to activate the RRT, and hospital-wide policies and practices most facilitated activation, whereas the categories of negative perceptions and concerns about RRTs and uncertainties surrounding RRT activation were the dominant barriers.
CONCLUSIONS: Facilitators and barriers to RRT activation were interrelated. Some facilitators like hospital leader and physician support of RRTs became barriers when absent. Intradisciplinary communication and collaboration between nurses can positively and negatively impact RRT activation. The expertise of RRT nurses should be further studied.
摘要：
背景：与快速反应团队（RRT）相关的结果不一致。这可能是由于受团队领导和卫生系统影响的潜在促进者和RRT激活的障碍。
目的：本研究的目的是综合美国（U.S.）已发表的关于护士主导的RRT激活的促进者和障碍的研究。
方法：进行系统评价。从2000年1月至2023年6月，搜索了四个数据库进行同行评审的定量，定性，以及报告RRT激活的促进因素和障碍的混合方法研究。在美国以外或由医生领导的团队进行的研究被排除在外。
结果：25项研究符合标准，有240,140名参与者，包括临床医生和住院成人。确定了促进者和RRT激活障碍的三个领域：(1)医院基础设施，（2）临床医生文化，和（3）护士的信念，属性，和知识。在每个域内识别类别。关于RRT的感知利益和积极信念的类别，知道何时激活RRT，以及医院范围内的政策和做法最有利于激活，而对RRT的负面看法和担忧以及围绕RRT激活的不确定性的类别是主要障碍。
结论：促进因子和RRT激活障碍是相互关联的。一些促进者，如医院领导和医生对RRT的支持，在缺席时成为障碍。护士之间的跨学科沟通和合作可以对RRT激活产生积极和消极的影响。应进一步研究RRT护士的专业知识。
目的：本研究的目的是综合美国（U.S.）已发表的关于护士主导的RRT激活的促进者和障碍的研究。
方法：进行系统评价。从2000年1月至2023年6月，搜索了四个数据库进行同行评审的定量，定性，以及报告RRT激活的促进因素和障碍的混合方法研究。在美国以外或由医生领导的团队进行的研究被排除在外。
结果：25项研究符合标准，有240,140名参与者，包括临床医生和住院成人。确定了促进者和RRT激活障碍的三个领域：(1)医院基础设施，（2）临床医生文化，和（3）护士的信念，属性，和知识。在每个域内识别类别。关于RRT的感知利益和积极信念的类别，知道何时激活RRT，以及医院范围内的政策和做法最有利于激活，而对RRT的负面看法和担忧以及围绕RRT激活的不确定性的类别是主要障碍。
结论：促进因子和RRT激活障碍是相互关联的。一些促进者，如医院领导和医生对RRT的支持，在缺席时成为障碍。护士之间的跨学科沟通和合作可以对RRT激活产生积极和消极的影响。应进一步研究RRT护士的专业知识。
