Evaluation of a patient and family activated escalation system: Ryan's Rule

Dwyer, Trudy; Flenady, Tracy; Kahl, Julie; Quinney, Loretto

doi:10.1016/j.aucc.2019.01.002

Cited by 24 publications

(50 citation statements)

References 56 publications

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“…Study design included: two qualitative, exploratory design studies 35,36 ; one qualitative cross‐sectional design study 37 ; one interpretive qualitative research design study 38 ; and one retrospective chart review with qualitative data 39 . One study was conducted in the UK, 35 three in Australia 36,38,39 and one in New Zealand 37 . Study characteristics are summarised in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…One study recruited from community‐based consumer organisations, 38 who had experiences of being patients or family members of past patients in acute hospitals. Age of participants ranged from 27 to 86 years in four studies, 35–38 the reporting of age from one study was restricted as patients age was grouped by gender 39 …”

Section: Resultsmentioning

confidence: 99%

“…One study had a patient and family‐initiated escalation of care intervention in place 39 . Remaining studies had EWS and RRS without a family escalation of care scheme.…”

Section: Resultsmentioning

confidence: 99%

“…Remaining studies had EWS and RRS without a family escalation of care scheme. Reporting of the intervention as per the TIDieR checklist 44 was limited, with only the name of the intervention, goal, and a limited overview of the procedures and activities outlined 39 …”

Section: Resultsmentioning

confidence: 99%

“…Five qualitative studies were included in the review, consisting of the experiences of 88 patients and 32 relatives reported in four studies 35–38 . One study 39 reported on the experiences and views of patients, relatives, and healthcare staff, however, did not clearly report on the sample size from each group (n = 56).…”

Section: The Reviewmentioning

confidence: 99%

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Patient and family involvement in escalating concerns about clinical deterioration in acute adult wards: A qualitative systematic review

McKinney

Fitzsimons

Blackwood

et al. 2020

Nursing in Critical Care

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Background Despite international standards for recognition and response to deterioration, warning signs are not always identified by staff on acute hospital wards. Patient and family‐initiated escalation of care schemes have shown some benefit in assisting early recognition, but are not widely used in many clinical practice areas. Objectives To explore (a) patients' and relatives' experiences of acute deterioration and (b) patients', relatives' and healthcare professionals' perceptions of the barriers or facilitators to patient and family‐initiated escalation of care in acute adult hospital wards. Methods We conducted a qualitative review using Cochrane methodology. Two reviewers independently screened studies, extracted data, and appraised the quality using a qualitative critical appraisal tool. Findings were analysed using thematic synthesis and confidence in findings was assessed using GRADE‐CERQual. Search strategy MEDLINE, CINAHL, EMBASE, PsychINFO databases and grey literature from 2005 to August 2019. Inclusion criteria Any research design that had a qualitative element and focused on adult patients' and relatives' experiences of deterioration and perceptions of escalating care. Results We included five studies representing 120 participants and assessed the certainty of evidence as moderate using GRADE‐CERQual. Findings indicated that a number of patients/relatives have the ability to detect acute deterioration, however, various factors act as both barriers and facilitators to being heard. These include personal factors, perceptions of role, quality of relationships with healthcare staff, and organisational factors. Theoretical understanding suggests that patient and relative involvement in escalation is dependent on both inherent capabilities and the factors that influence empowerment. Conclusion This review highlights that patient and family escalation of care interventions need to be designed with the aim of improving patient/relative—clinician collaboration and the sharing of responsibility. Relevance to practice These factors need to be addressed to promote more active partnerships when designing and implementing patient and family‐initiated escalation of care interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…One study had a patient and family‐initiated escalation of care intervention in place 39 . Remaining studies had EWS and RRS without a family escalation of care scheme.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: The Reviewmentioning

confidence: 99%

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