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  1. Mininni, Nicolette C. DNP, MEd, RN, CCRN-K
  2. Whiteman, Kimberly DNP, RN
  3. Stephens, Kimberly DNP, RN
  4. George, Elisabeth PhD, RN
  5. Swanson-Biearman, Brenda DNP, RN


Background: Rapid response teams (RRTs) are designed to improve patient care during deterioration in clinical condition.


Local Problem: Patients' desired limitations of medical therapy (LOMTs) were not documented or communicated to the RRT, and patients received care not aligned with their wishes.


Methods: A multidisciplinary team developed a process for improving documentation, communication of LOMTs, and care delivery on 3 medical cardiology units. The team implemented 3 Plan-Do-Study-Act (PDSA) cycles over 6 months.


Interventions: In cycle 1, team members taught the unit nurses, RRT members, and physicians to share LOMTs during handoff communications. Cycle 2 engaged case managers in LOMT documentation. In cycle 3, unit-based RRT simulation was conducted.


Results: All care delivered by the RRT aligned with the documented LOMTs. Documentation of LOMTs increased from 76% to 82.5% (P = .014).


Conclusions: Education, scripting, and simulation were successful strategies to ensure that care given during RRT events aligned with patients' wishes.