Predicting patient acuity according to their main problem

Juvé‐Udina, Maria‐Eulàlia; Adamuz, Jordi; López-Jiménez, María-Magdalena; Tàpia‐Pérez, Marta; Fabrellas, Núria; Matud-Calvo, Cristina; González-Samartino, Maribel

doi:10.1111/jonm.12885

Cited by 14 publications

(13 citation statements)

References 37 publications

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“…Patients with lower levels of acuity were more likely to have improved outcome. This finding was consistent with the findings of previous studies showing that patients with higher acuity levels had higher mortality or in-hospital adverse events (Juvé-Udina et al, 2019). As care factors, medical patients tended to have worse outcomes than did surgical patients.…”

Section: Discussionsupporting

confidence: 92%

Relationships between the National Early Warning Score 2, clinical worry and patient outcome at discharge: Retrospective observational study

Hwang

Chin

2020

Journal of Clinical Nursing

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Aims and objectives To examine the performance of the National Early Warning Score 2 and composite score for clinical worry in identifying patients at risk of clinical deterioration, and to determine relationships between National Early Warning Score 2, clinical worry score and patient outcome at discharge. Background The efficacy of early warning systems depends on patient population and care settings. Based on a theoretical framework on factors affecting clinical deterioration and patient outcomes, studies exploring the relationship between early warning systems and patient outcomes at discharge are sparse. Design Retrospective observational study. Methods A random sample of 732 medical records were reviewed. The area under the receiver operating characteristic curve was calculated to evaluate predictive abilities regarding the events of unanticipated in‐hospital mortality, unplanned intensive care unit/ higher dependency bed admission and cardiac arrest. Multiple logistic regression analyses were performed to determine relationships between National Early Warning Score 2, clinical worry score and patient outcome. Reporting followed the STROBE checklist. Results National Early Warning Score 2 and clinical worry score significantly predicted the events within 24 hr of the assessment. After controlling for other patient, treatment and organisational characteristics, National Early Warning Score 2 was a significant factor associated with patient outcome, but clinical worry score was not. Specifically, patients at high risk based on National Early Warning Score 2 were less likely to have improved outcome. Conclusions National Early Warning Score 2 and clinical worry score performed well for predicting deteriorating condition of patients. National Early Warning Score 2 was significantly associated with patient outcome. It can be used for efficient patient management for safe, quality care. Relevance to clinical practice National Early Warning Score 2 can be used for early assessment of not only clinical deterioration but also patient outcome and provide timely intervention, when coupled with clinical worry score.

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Section: Discussionsupporting

confidence: 92%

Relationships between the National Early Warning Score 2, clinical worry and patient outcome at discharge: Retrospective observational study

Hwang

Chin

2020

Journal of Clinical Nursing

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“…Considering that NSC is estimated for safe care, the similarities in acuity distribution between a previous study with 2016-2017 data (Juvé-Udina et al, 2019)…”

Section: Implications For Nursing Managementmentioning

confidence: 87%

“…The acute to intensive care (ATIC) patient classification system was used to measure acuity (Table 1). Based on the weight of the patient main problem, this tool is structured into ten acuity groups and their equivalence to r NHPPD, ranging from occasional to gigaintensive required nursing intensity (Juvé‐Udina et al., 2019).…”

Section: Methodsmentioning

confidence: 99%

“…Conversely, a recent study reported two thirds of adult ward inpatients match high-acuity profiles, equivalent to an average of 5.6 rNHPPD (Juvé-Udina et al, 2019). Overwhelming demands lead nurses to prioritization of patients and care without complete situational awareness, while adequate staffing based on patient acuity is perceived by frontline nurses as a critical issue for safe patient care (Hegney et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

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Acuity, nurse staffing and workforce, missed care and patient outcomes: A cluster‐unit‐level descriptive comparison

et al. 2020

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“…Several studies have demonstrated the association between acute status and other patient and organizational measures, and nurse-sensitive outcomes such as mortality and the AE studied here. Nevertheless, further studies are required that combine acuity and complexity measures, as well as organizational variables such as nurse staffing or missed care, to gain a better understanding of their role in patient outcomes [ 56 – 58 ].…”

Section: Discussionmentioning

confidence: 99%

Care complexity individual factors associated with adverse events and in-hospital mortality

et al. 2020

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Introduction Measuring the impact of care complexity on health outcomes, based on psychosocial, biological and environmental circumstances, is important in order to detect predictors of early deterioration of inpatients. We aimed to identify care complexity individual factors associated with selected adverse events and in-hospital mortality. Methods A multicenter, case-control study was carried out at eight public hospitals in Catalonia, Spain, from January 1, 2016 to December 31, 2017. All adult patients admitted to a ward or a step-down unit were evaluated. Patients were divided into the following groups based on the presence or absence of three adverse events (pressure ulcers, falls or aspiration pneumonia) and in-hospital mortality. The 28 care complexity individual factors were classified in five domains (developmental, mental-cognitive, psycho-emotional, sociocultural and comorbidity/complications). Adverse events and complexity factors were retrospectively reviewed by consulting patients' electronic health records. Multivariate logistic analysis was performed to identify factors associated with an adverse event and in-hospital mortality. Results A total of 183,677 adult admissions were studied. Of these, 3,973 (2.2%) patients experienced an adverse event during hospitalization (1,673 [0.9%] pressure ulcers; 1,217 [0.7%] falls and 1,236 [0.7%] aspiration pneumonia). In-hospital mortality was recorded in 3,996 patients (2.2%). After adjustment for potential confounders, the risk factors independently associated with both adverse events and in-hospital mortality were: mental status impairments, impaired adaptation, lack of caregiver support, old age, major chronic disease, hemodynamic instability, communication disorders, urinary or fecal incontinence, vascular

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Predicting patient acuity according to their main problem

Cited by 14 publications

References 37 publications

Relationships between the National Early Warning Score 2, clinical worry and patient outcome at discharge: Retrospective observational study

Relationships between the National Early Warning Score 2, clinical worry and patient outcome at discharge: Retrospective observational study

Acuity, nurse staffing and workforce, missed care and patient outcomes: A cluster‐unit‐level descriptive comparison

Care complexity individual factors associated with adverse events and in-hospital mortality

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