Investigating ward nurses’ responses to deteriorating patients

Loftus, Nicholas Woolfe; Smith, Duncan

doi:10.7748/ns.2019.e11020

Cited by 3 publications

(1 citation statement)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[32][33][34][35][36][37][38][39][40] A common problem is related to failure to assess respiratory rate, 35 39 40 ineffective and poor communication, especially among healthcare workers. [41][42][43] Lack of staff and time have also been shown to negatively affect the use of EWSs. 35 40 43 A recent systematic review identified that escalation was largely influenced by perceptions; notably, junior doctors' perception of threatened deskilling and appearing incompetent due to the presence of RRTs.…”

Section: Suboptimal Usementioning

confidence: 99%

Understanding the use of the National Early Warning Score 2 in acute care settings: a realist review protocol

et al. 2022

View full text Add to dashboard Cite

IntroductionFailure to recognise and respond to patient deterioration in an appropriate and timely manner has been highlighted as a global patient safety concern. Early Warning Scores (EWSs) using vital signs were introduced to address this concern, with the aim of getting the patient timely and appropriate treatment. The National Early Warning Score 2 (NEWS2) is in use across the NHS, and many other settings globally. While patient improvements have been shown, research has identified that the NEWS2 is not always used as intended. Therefore, this review will use a realist approach to understand what the mechanisms are that influence appropriate use (or not) of the NEWS2 in acute care settings, how, for whom and in which contexts. The findings will inform clinicians of what helps and/or hinders appropriate use of the NEWS2 in clinical practice, thus helping to facilitate successful implementation.Methods and analysisOur realist review will follow Pawson’s iterative six step process: (1) Development of initial programme theory. (2) Searching the literature; an information scientist will develop, pilot and refine the search strategy. A systematic search will be completed, based on subject relevancy on the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase (OvidSP), Web of Science (Science Citation Index and Social Science Citation), Cochrane Database of Systematic Reviews, Joanna Briggs Institute, Ethos, Proquest Dissertations and Theses Global, and Google Scholar for documents dating from 1997 (date of the first published EWS) to present. To retrieve additional relevant data ‘snowballing’ (finding references and authors by hand, contacting authors, searching reference lists and citation-tracking using Google Scholar) will be used. Inclusion criteria include all documents (including grey literature) that relate to the use of EWSs/NEWS2 in the English language only. Documents set in the paediatric, maternity and primary care settings will be excluded. (3) Selecting documents and quality appraisal. (4) Extracting and organising the data. (5) Synthesising the data. (6) Disseminating the findings. We will recruit a group of stakeholders comprised of experienced clinicians who use the NEWS2 as part of their clinical practice to provide feedback throughout the review. Step 1 has already begun with the development of an initial programme theory. This initial programme theory presents how the NEWS2 is supposed to work (or not), it will now be developed, tested and refined.Ethics and disseminationEthical approval is not required for this study as it is secondary research. Dissemination will include a peer-reviewed publication and conference presentations. Findings will also be amplified through social media platforms with user friendly summaries. Our stakeholder group will also contribute to dissemination of findings in their clinical areas and among existing networks.PROSPERO registration numberCRD42022304497.

show abstract

Section: Suboptimal Usementioning

confidence: 99%

Understanding the use of the National Early Warning Score 2 in acute care settings: a realist review protocol

et al. 2022

View full text Add to dashboard Cite

show abstract

Use of rapid response system afferent limb to recognize and respond to deteriorating patients: An action research study

Julnes

Reitan

Myrvang

et al. 2022

Nordic Journal of Nursing Research

View full text Add to dashboard Cite

Failure to recognize the deterioration of hospital patients has led to the implementation of a system known as the Rapid Response System. The aim was to explore nurses’ use of the afferent limb of the Rapid Response System to recognize and respond to deteriorating patients. Data were collected via video recordings with observations of 20 registered nurses (RNs) from general wards performing scenarios in a simulation laboratory with focus group interviews. Data were analyzed using systematic text condensation. COREQ were followed. In the first scenario, nurses did not apply ABCDE or ISBAR, and the use of NEWS was insufficient. Completing an education program led to evident improvement in the use of the tools during the second scenario. Nurses initially viewed their new competency as useful, but it was not sustained a year later. Customized education programs and fidelity-scale simulations are suited but not sufficient to change clinical competency without management anchoring.

show abstract

Effects of a Rapid Response Team on the Clinical Outcomes of Cardiopulmonary Resuscitation of Patients Hospitalized in General Wards

Yoon¹,

Park²

2021

J Korean Acad Fundam Nurs

View full text Add to dashboard Cite

Purpose: This study investigated differences in the clinical outcomes of cardiopulmonary resuscitation (CPR) of patients hospitalized in general wards according to the operation of a rapid response team.Methods: This retrospective study included 122 patients over the age of 19 who were admitted to general ward of a hospital located in Suwon, between July 1, 2015 and December 31, 2019, and received CPR during the operating hours of the rapid response team. The collected data were analyzed by descriptive statistics, the x2 test, Fisher's exact test, and one-way analysis of variance using SPSS for Windows version 25.0.Results: The proportion of nurses who were the initial responders to cardiac arrest was 79.1% during the extended-operation period. 41.2% during the pre-operation period, and 42.2% during the limited-operation period (p<.001). The rate of good neurological recovery at discharge post-CPR was 25.0% in patients who received CPR during the pre-operation period, 36.4% during the limited-operation period, and 87.5% during the extended-operation period (p=.042).Conclusion: This study identified clinical outcomes in patients who received CPR according to the operation status of the rapid response team. These results are expected to help in the further implementation of rapid response teams.

show abstract

Investigating ward nurses’ responses to deteriorating patients

Cited by 3 publications

References 23 publications

Understanding the use of the National Early Warning Score 2 in acute care settings: a realist review protocol

Understanding the use of the National Early Warning Score 2 in acute care settings: a realist review protocol

Use of rapid response system afferent limb to recognize and respond to deteriorating patients: An action research study

Effects of a Rapid Response Team on the Clinical Outcomes of Cardiopulmonary Resuscitation of Patients Hospitalized in General Wards

Contact Info

Product

Resources

About