Perceptions, barriers, and methods for the early detection and intervention of clinical deterioration in hospitalized adults
Abstract
"Significant clinical changes in neurological and respiratory function of patients are associated with increased mortality. Minor changes of these functions have been noted within 24 hours of an inpatient death associated with a clinical decline (CD) event (Buist et al., 2004). Components of detection tools are founded on evidence that is overwhelmingly retrospective. A common limitation of CD detection is that these tools are often accurate at predicting decline but are not as successful at preventing decline (Downey et al., 2017). These tools emphasize the predictability of decline from data that already exists within the Electronic Health Record (EHR), primarily vital signs and neurological function (Downey et al., 2017). A growing body of evidence suggests indicators of nursing concern and usability have been excluded from these tools (Jensen et al., 2019). A landmark study from the Institute of Medicine estimates roughly 44,000-98,000 preventable inpatient deaths occur every year within the US (Donaldson, Corrigan, & Kohn, 2000). Exploring the role of nursing in preventing the failure to rescue phenomenon will play a pivotal role in reducing preventable harm and death for adults receiving inpatient care."--Introduction.