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Investigating ward nurses' responses to deteriorating patients.
Nicholas Woolfe Loftus1, Duncan Smith2
1Coronary Care Unit, St Bartholomew's Hospital, Barts Health NHS Trust, London.
Nursing Standard (Royal College of Nursing (Great Britain) : 1987)
|September 19, 2018
Summary
Recognizing and responding to deteriorating patients is crucial. Effective communication, adequate nurse staffing, and improved knowledge, including
Area of Science:
- Nursing care
- Patient safety
- Clinical response
Background:
- Deteriorating patients often exhibit suboptimal vital signs, necessitating prompt recognition and intervention by healthcare staff.
- Failure to recognize or respond to patient deterioration can lead to severe complications and increased mortality.
- Despite existing initiatives, ward nurses' recognition and response to deteriorating patients remain suboptimal.
Purpose of the Study:
- To identify key factors influencing ward nurses' responses to deteriorating patients.
- To understand the elements affecting the trigger component of nurses' afferent response to patient decline.
Main Methods:
- A comprehensive literature review was conducted.
- Electronic databases and hand-searching were employed to identify relevant studies.
- Inclusion and exclusion criteria were applied to select studies for the review.
Main Results:
- Nine studies were included in the literature review.
- Four primary themes emerged: communication, diurnal/weekend variations, knowledge/attitudes, and nurse staffing levels.
- These themes significantly influence how ward nurses respond to deteriorating patients.
Conclusions:
- Effective communication is vital for enhancing nurses' responses to deteriorating patients.
- Improved knowledge, particularly regarding 'do not attempt cardiopulmonary resuscitation' (DNACPR) orders, is important.
- Increased nurse staffing and senior staff availability empower junior staff to escalate care effectively.