Understanding how medications contribute to clinical deterioration and are used in rapid response systems: A comprehensive scoping review

Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses
Bianca J LevkovichMichael J Dooley

Abstract

In hospitals, rapid response systems (RRSs) identify patients who deteriorate and provide critical care at their bedsides to stabilise and escalate care. Medications, including oral and parenteral pharmaceutical preparations, are the most common intervention for hospitalised patients and the most common cause of harm. This connection between clinical deterioration and medication safety is poorly understood. To inform improvements in prevention and management of clinical deterioration, this review aimed to examine how medications contributed to clinical deterioration and how medications were used in RRSs. A scoping review was undertaken of medication data reported in studies of clinical deterioration or RRSs in diverse hospital settings between 2005 and 2017. Bibliographic database searches used permutations of "rapid response system," "medical emergency team," and keyword searching with medication-related terms. Independent selection, quality assessment, and data extraction informed mapping against four medication themes: causes of deterioration, predictors of deterioration, RRS use, and management. Thirty articles were reviewed. Quality was low: limited by small samples, observational, single-centre designs and few primary med...Continue Reading

Citations

Jul 15, 2020·European Journal of Hospital Pharmacy. Science and Practice·Salah AbuRuzAmira Said
Apr 28, 2021·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·Bianca J LevkovichCarl M Kirkpatrick
Aug 10, 2021·Therapeutic Advances in Drug Safety·Chariclia ParadissisMichael Barras

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