Rapid response teams in both adult and pediatric settings have proven to be invaluable, significantly decreasing morbidity and mortality rates. However, specific pediatric rapid response team, or PRRT, activation triggers are not well established in pediatric studies. At Rush Children’s Hospital, a proactive approach has been taken to bridge this gap, ensuring that pediatric patients receive critical care expertise right at their bedside.
Activating Expertise
Pediatric rapid response events are activated by general pediatric clinicians to bring pediatric critical care expertise in medicine, nursing and respiratory therapy to a child’s bedside. Debriefing sessions have revealed challenges in knowledge, skills and attitudes of “activators” and “responders.” Understanding these hurdles was the first step toward improvement.ately 350 nurses are expected to complete the training.
A Collaborative Effort
In mid-2023, the Pediatric Rapid Response Committee was established, overseen by pediatric nursing, medical and respiratory therapy leadership and staff nurses from both the general pediatric unit and pediatric intensive care unit, or PICU. The committee’s mission was clear: evaluate events based on the PRRT activation criteria and response algorithms, identify trends and implement effective interventions to support the rapid response process.
Empowering Clinicians Through Education and Simulation
The committee reviewed all policies and clinical resources pertaining to pediatric rapid responses. The review led to important documentation updates, including enhancements to the flowsheet documentation on the Pediatric Early Warning Score, or PEWS, and an updated electronic event debrief form. The changes not only improved data collection but also strengthened the overall evaluation of the PRRT processes.
With the knowledge gained from this data collection and evaluation stage, the committee moved into action, planning didactic and simulation training sessions to improve knowledge, skills and attitudes of activating and responding clinicians. The educational sessions covered the benefits of PRRT, a summary of policies and clinical resources, including PEWS, activation requirements, documentation, roles/responsibilities and essential communication skills, including effective debriefing practices. The simulation exercises focused on the most frequent rapid response scenarios, such as respiratory distress, seizures and sepsis/ systemic inflammatory response syndrome. In late 2024 and early 2025, PRRT sessions were attended by nearly 80 registered nurses and all pediatric resident physicians.
Expanding Impact
Overall, approximately 80 nurses attended PRRT education sessions, including all general pediatric, PICU, and Department of Women, Children and Family Nursing nurses. Additionally, all pediatric residents received a PRRT session during a conference.
The reach of PRRT process is expanding. As the Pediatric Rapid Response Committee was launching, a Rush University College of Nursing Doctor of Nursing Practice, or DNP, student, who is also a PICU registered nurse, completed an evaluation project of PRRT processes. Another PICU registered nurse is completing a DNP project to evaluate the effectiveness of the PRRT didactic and simulation course.
Continued Commitment to Patient Safety
The Pediatric Rapid Response Committee continues to strive to highlight the importance of continued evaluation of patient safety initiatives by formally reviewing PRRT events monthly, continuing education for new registered nurses and medical residents and auditing documentation. In fact, a group of Rush University College of Nursing Generalist Entry Master’s in Nursing students is actively engaged in documentation audits, further emphasizing the multidisciplinary teamwork that defines the committee’s initiative. By fostering a culture of collaboration and education, Rush is setting a standard that benefits our youngest patients and enhances their quality of care.