Outreach and Early Warning Systems (EWS) for the prevention of intensive care admission and death of critically ill adult patients on general hospital wards

McGaughey, Jennifer; Alderdice, Fiona; Fowler, Rob; Kapila, Atul; Moutray, Marianne

doi:10.1002/14651858.cd005529

Cited by 101 publications

(145 citation statements)

References 22 publications

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“…While early detection of the deteriorating patient is possible by the use of simple physiological variables, such as respiratory rate,10 11 in-hospital deployment of medical emergency teams as a response has not proven to be effective 12 13. That is, while the deteriorating patient may be detected prior to a health crisis, that detection does not necessarily lead to improved outcomes in the medical emergency teams model.…”

Section: Discussionmentioning

confidence: 99%

What causes adverse events in prehospital care? A human-factors approach

et al. 2012

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BackgroundThe last decade has seen a vast amount of work directed at the investigation of patient harm events. Unfortunately, little of it has pertained to prehospital care and as such, risk remains unquantified and poorly understood in this setting. We hypothesised that adverse patient events occurring during the prehospital phase may fall into discernible patterns, and that an understanding of these patterns would be valuable in the development of mitigation strategies.MethodsA survey tool was developed with reference to the human factors literature. Paramedics in a large Australian ambulance service were asked to recall an adverse event and to nominate factors that may have contributed to its occurrence. Responses were analysed using principal components analysis in order to identify contributory factors that could be statistically grouped together in meaningful patterns.ResultsThe survey yielded 370 responses. Eight key single contributors and 14 groups of contributory factors were identified. Of the groups, only two were strongly associated with serious patient outcomes, such as reported significant deterioration or death.ConclusionsThe deteriorating patient was identified as the leading single contributor to prehospital adverse events, and two perfect storm patient harm scenarios were found to contribute materially to adverse outcomes. This approach to identifying both single factors contributing to an incident and factors which could be grouped together in a pattern, appears useful in delineating risk in the acute prehospital setting, and warrants further exploration in this and other areas of patient safety.

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Section: Discussionmentioning

confidence: 99%

What causes adverse events in prehospital care? A human-factors approach

et al. 2012

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“…This diversity makes it problematic to determine what such a service should include (Williams & Leslie 2008, Endacott et al 2009, McGaughey et al 2009). …”

Section: Introductionmentioning

confidence: 99%

Integrative review of nurse‐led follow‐up after discharge from theICU

Jónasdóttir

Klinke

Jónsdóttir

2015

Journal of Clinical Nursing

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“…Although it is hoped that "track and trigger" systems (frequent recording of vital signs coupled with the use of early warning scores) will be beneficial, results to date have been disappointing. 12 Finally, we need high quality epidemiological data about surgical risk and outcome. Although the registries of surgical societies monitor specific complications of defined procedures, high quality generic perioperative datasets to compare institutions and systems (for example, NHS and private provision) are not widely available in the UK.…”

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confidence: 99%