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Title: Systems for recognition and response to clinical deterioration in Victorian emergency departments.
Austin Authors: Considine, Julie;Rhodes, Kerryn;Jones, Daryl A ;Currey, Judy
Affiliation: Deakin University, Geelong, School of Nursing and Midwifery and Centre for Quality and Patient Safety Research, Victoria, Australia
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Deakin University, Geelong, School of Nursing and Midwifery, Victoria, Australia
Centre for Quality and Patient Safety Research - Eastern Health Partnership, Box Hill, Victoria, Australia
Wimmera Health Care Group, Horsham, Victoria, Australia
Issue Date: Feb-2018 2018-03-21
Publication information: Australasian emergency care 2018; 21(1): 3-7
Abstract: The study aim was to explore the systems for recognising and responding to clinical deterioration in adult and paediatric Victorian emergency department (ED) patients after their initial triage assessment. A survey of Victorian EDs was conducted. Senior ED nursing staff was asked about ED characteristics, vital sign documentation, systems for recognising and responding to deteriorating ED patients, quality assurance and governance of ED rapid response systems (RRSs). Sixteen EDs participated (17 metropolitan and 13 regional or rural) giving a response rate of 53.3% (16/30). The organisational definition of a deteriorating patient applied to the ED at 50% of sites (n=8). Vital sign documentation was paper-based (43.6%), electronic (37.6%) or a combination (18.8%) of both. The majority of EDs (87.5%, n=14) had an ED RRS; 50% had one tier, single trigger RRS and 31.3% of EDs had a two tier, single trigger RRS. At 68.8% of sites the ED RRS activation criteria were the same as ward MET (medical emergency team) activation criteria. The most common method of escalation of care for deteriorating ED patients were face-to-face communication (87.5%) and overhead announcements within the ED (68.8%). The ED rapid response team (RRT) was composed of ED specific staff in 50.5% of sites, and staff external to the ED at 12.5% of sites. Two thirds of sites (68.7%) collected data about clinical deterioration in ED patients. Most EDs had an RRS but there was variability in activation criteria and members of the responding team both between EDs, and between ED and the ward RRSs.
DOI: 10.1016/j.auec.2017.12.003
Journal: Australasian emergency care
PubMed URL: 30998862
Type: Journal Article
Subjects: Clinical deterioration
Clinical risk management
Emergency department
Emergency nursing
Rapid response teams
Appears in Collections:Journal articles

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