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The Impact of Rapid Response Systems on Not-For-Resuscitation (NFR) Orders

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Textbook of Rapid Response Systems

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Abstract

Rapid response teams (RRT) influence the issuing of NFR orders, with up to 24% of RRT calls involve documentation of NFR orders. This is to be expected as certain conditions demonstrate physiological disturbances as death approaches or such circumstances are precipitated by acute deterioration following an acute, unrelated illness. Furthermore, up to 35% of RRT calls are for patients with preexisting NFR orders, often within 24 h of their time of death. Overtime, RRT activity has evolved to be associated with issuing of other, related orders (e.g., not for RRT, modified RRT). The role of the RRT in end of life decisions and care will continue to evolve as RRT activity continues to increase and hospital wide strategies to better identify and manage patients at their end of life also evolve. There is potential for patient benefit of a closer association between critical care based RRT and palliative care services.

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Author information

Authors and Affiliations

  1. Intensive Care Unit, Royal Adelaide Hospital and Faculty of Health Sciences, School of Medicine, University of Adelaide, North Tce, Adelaide, South Australia, 5001, Australia

    Arthas Flabouris

  2. Simpson Centre for Health Services Research, South Western Sydney Clinical School, University of New South Wales, Level 1, AGSM Building, Sydney, New South Wales, Australia

    Jack Chen

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  1. Arthas Flabouris
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  2. Jack Chen
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Correspondence to Arthas Flabouris .

Editor information

Editors and Affiliations

  1. Department of Surgery, Critical Care, Harlem Hospital Center, New York, New York, USA

    Michael A. DeVita

  2. The Simpson Centre for Health Services Research, South Western Sydney Clinical School, UNSW Sydney, the Ingham Institute for Applied Medical Research and Intensive Care, Liverpool Hospital, Liverpool BC, New South Wales, Australia

    Ken Hillman

  3. Department of Intensive Care, Austin Hospital, Heidelberg, Victoria, Australia

    Rinaldo Bellomo

  4. Royal Berkshire NHS Foundation Trust, Reading, Berkshire, United Kingdom

    Mandy Odell

  5. Intensive Care Unit, Austin Hospital, Heidelberg, Victoria, Australia

    Daryl A. Jones

  6. Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    Bradford D. Winters

  7. Department of Anesthesia, Stanford University School of Medicine, Palo Alto, California, USA

    Geoffrey K. Lighthall

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Flabouris, A., Chen, J. (2017). The Impact of Rapid Response Systems on Not-For-Resuscitation (NFR) Orders. In: DeVita, M., et al. Textbook of Rapid Response Systems. Springer, Cham. https://doi.org/10.1007/978-3-319-39391-9_36

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  • DOI: https://doi.org/10.1007/978-3-319-39391-9_36

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