Clinical deterioration of ward patients in the presence of antecedents: A systematic review and narrative synthesis

Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses
Modi Al-MoteriMark Symmons

Abstract

The aim of this review was to identify and synthesise published accounts of recognising and responding to patient deterioration in the presence of deterioration antecedents. The systematic review canvassed four electronic databases/search engines for studies of adult ward patients who had altered physiological parameters before developing major adverse events. The findings were synthesised using a narrative approach. Clinical deterioration can be missed by nurses, even with adequate charting. Delays in recognising and responding to patient deterioration remains an international patient safety concern, and strategies to enhance recognition of patient deterioration have not achieved consistent improvements. The lack of significant and sustained improvement through targeted training suggests the problem may be rooted in human behaviour and local ward culture. Nurses play a pivotal role in recognising and responding to patient deterioration; however, patient records do not facilitate tracking of all nurse decisions and actions, and any undocumented care cannot be easily captured by auditing processes. Failure to recognise clinical deterioration was evident even with adequate charting. It is not clear if nurses do not recognise clin...Continue Reading

Citations

Feb 8, 2021·Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN·Samantha Bernstein
Dec 1, 2020·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·Wei Ling ChuaSok Ying Liaw
Jul 1, 2021·Journal of Professional Nursing : Official Journal of the American Association of Colleges of Nursing·Modi Al-MoteriMohammed Al Malki

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