Rapid response team knowledge, attitudes, and self-reported compliance among general ward nurses in two tertiary teaching hospitals in Zhejiang, China: a cross-sectional study

Nurses play a pivotal role in the timely activation of Rapid Response Teams (RRTs) for early intervention in patient deterioration. However, little is known about nurses’ RRT knowledge, attitudes, and self-reported compliance with RRT activation criteria, particularly in the Chinese context. This study aimed to examine nurses’ RRT knowledge, attitudes, and self-reported compliance, and to identify factors associated with these outcomes among general ward nurses working in two tertiary teaching hospitals in Zhejiang, China. A descriptive, two-centre cross-sectional study was conducted among nurses working in general wards of two tertiary teaching hospitals in Hangzhou and Yiwu, China. A self-administered online questionnaire was distributed. Multivariable linear regression was used to examine factors associated with the RRT knowledge scenario score and RRT attitude summary score, while multivariable ordinal logistic regression was used to identify factors associated with the self-reported compliance criterion-count index. Among the 779 nurses included, the mean RRT knowledge scenario score was 3.59 ± 1.30, the mean RRT attitude summary score was 51.00 ± 6.05, and the median (IQR) self-reported compliance criterion-count index was 3 (4). The RRT knowledge scenario score was significantly associated with age and having activated an RRT call at least once. The RRT attitude summary score was associated with age, hospital site, job title, RRT knowledge scenario score, perceived clarity of RRT activation criteria, unit culture, team characteristics, and RRT training score. Domain-specific sensitivity analyses showed variation in these associations across the three attitude domains. Overall, 27.1% of the nurses were classified as having good self-reported compliance according to the study-defined descriptive classification. In the primary analysis, hospital site, RRT knowledge scenario score, perceived clarity of RRT activation criteria, and RRT training score were associated with higher levels of self-reported compliance; the hospital-site association was model-dependent across sensitivity analyses. The RRT knowledge scenario score, perceived clarity of RRT activation criteria, and RRT training score were associated with self-reported compliance. Given the cross-sectional design and the use of self-reported measures, these findings should be interpreted as concurrent associations rather than evidence of causal effects or objectively verified RRT activation behaviour. Prospective studies using objective activation measures are needed to further examine these relationships.