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Updated: Dec 24, 2025
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Development of a Standardized System to Detect and Treat Early Patient Deterioration
Rebecca Ashbeck1, Courtney Stellpflug, Eriana Ihrke
1Department of Nursing, Mayo Clinic, Rochester, Minnesota (Mss Ashbeck, Stellpflug, Ihrke, Fraune, and Holst and Mr Marsh); Department of Nursing, Mayo Clinic Health System, Red Wing, Minnesota (Ms Brummel).
Background:
Inpatient nurses identified the need to recognize clinical deterioration earlier, including rapid response team (RRT) activations and transfers to the intensive care unit. Surveys identified the need for better interdisciplinary communication.
Local Problem:
A system was needed to detect early clinical deterioration with structured responses promoting multidisciplinary collaboration.
Methods:
An early warning score (EWS) identified patients at risk. The system ensured timely and accurate actions were taken when scores reached 3 or above.
Interventions:
Collaborative, graded responses to EWSs and nurse-led rounds promoted communication and timely interventions.
Results:
Mortality decreased (-27%) as did multiple RRT activations on a single patient (-15%). Nurses are aware of early vital sign changes (+45%) and resident responsiveness has improved. There has been an increase in nurse/resident communication satisfaction (+31%).
Conclusions:
The system implemented reinforces the importance of patient assessment, collaboration among the multidisciplinary team, and promotes early interventions.
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