• Debbie Massey, Leanne M Aitken, and Wendy Chaboyer.
• Research Centre for Clinical and Community Practice Innovation, Griffith University and Princess Alexandra Hospital, Brisbane, Qld, Australia. d.massey@griffith.edu.au
• J Clin Nurs. 2010 Dec 1;19(23-24):3260-73.

AimsTo conduct a literature review that explores the impact of rapid response systems on reducing major adverse events experienced by deteriorating ward patients.BackgroundPatients located on hospitals wards are frequently older, have multiple co-morbidities and are often at risk of life-threatening clinical deterioration. Rapid response systems have been developed and implemented to provide appropriate and timely intervention to these patients.DesignA comprehensive review of the literature.MethodsThis review used the rapid response systems framework recently developed by experts in the area. Medline, CINAHL, Embase and Cochrane databases were searched from January 1995-June 2009. Sixteen papers were selected that most clearly reflected the research aim. Each paper was critically appraised and systematically assessed. Major themes and findings were identified for each of the studies.ResultsThe effectiveness of rapid response systems in reducing major adverse events in deteriorating ward patients remains inconclusive. Six studies demonstrated that the introduction of a rapid response systems positively impacted on patient outcomes, but three studies demonstrated no positive impact on patient outcomes. Nursing staff appear reluctant to use rapid response systems; the rationale for this is unclear. However, the continued underuse and inactivation may be one reason why research findings evaluating rapid response systems have been inconclusive.Conclusions The paper illustrates two important gaps in the literature. First, 'ramp-up' systems have not been subjected to formal evaluation. Second, rapid response systems are under-activated and underused by nursing staff. There is an urgent need to explore the reasons for this and to identify interventions to improve the activation of these systems in an effort to promote safe and effective care to the deteriorating ward patient.Relevance To Clinical PracticeRapid response systems are multidimensional models. They are relatively new innovations that have important implications for clinical research and implementation policy. This review contributes to the emerging debate on rapid response systems.© 2010 Blackwell Publishing Ltd.

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