Australian Critical Care
Volume 23, Issue 4 , Pages 188-196 , November 2010

‘Changes of concern’ for detecting potential early clinical deterioration: A validation study

  • Jane Cioffi, PhD

      Affiliations

    • School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, Penrith South DC, NSW 1797, Australia
    • Corresponding Author InformationCorresponding author. Tel.: +61 2 96859115; fax: +61 2 96859023.
  • ,
  • Richard Conway, MA

      Affiliations

    • Sydney West Area Health Service, PO Box 533, Wentworthville, NSW 2145, Australia
    • Tel.: +61 2 98455555; fax: +61 2 98455000.
  • ,
  • Leanne Everist

      Affiliations

    • Sydney West Area Health Service, Blacktown Road, Blacktown, NSW 2148, Australia
    • Tel.: +61 2 98811800; fax: +61 2 9881 1586.
  • ,
  • Janet Scott, BHSc

      Affiliations

    • Sydney West Area Health Service, PO Box 63, Penrith, NSW 2751, Australia
    • Tel.: +61 2 47342147; fax: +61 2 47343134.
  • ,
  • John Senior, BAppSc (Nursing)

      Affiliations

    • NSW College of Nursing, Australia
    • Sydney West Area Health Service, Norval St., Auburn, NSW 2144, Australia
    • Tel.: +61 2 87593608; fax: +61 2 87593123.

Received 26 May 2009 ,Revised 16 March 2010 ,Accepted 30 April 2010.

References 

  1. Gao H, McDonnell A, Harrison D, Moore T, Adam S, Daly K, et al. Systematic review and evaluation of physiological track and trigger warning systems for identifying at-risk patients on the ward. Intensive Care Med. 2007;33(4):667–679
  2. Winters BD, Pham JC, Hunt EA, Guallar E, Berenholtz S, Pronovost PJ. Rapid response systems: a systematic review. Crit Care Med. 2007;35(5):1238–1243
  3. Garcea G, Thomasset S, McClelland L, Leslie A, Berry DP. Impact of a critical care outreach team on critical care readmissions and mortality. Acta Anaesthesiol Scand. 2004;48(9):1096–1100
  4. Hodgetts TJ, Kenward G, Vlachonikolis IG, Payne S, Castle N. The identification of risk factors for cardiac arrest and formulation of activation criteria to alert a medical emergency team. Resuscitation. 2002;54(2):125–131
  5. National Institute for Health and Clinical Excellence. Acutely ill patients in hospital: recognition of and response to acute illness in adults in hospital (NICE clinical guideline 50) July 2007. Available from www.nice.org.uk/CG050FullGuideline.Short.pdf.
  6. Greater Metropolitan Clinical Taskforce. GMCT guidelines for in-hospital clinical emergency response systems for medical emergencies, 2005; Harrison GA and GMCT CERS Working Group.
  7. Santiano N, Young L, Hillman K, Parr M, Jayasinghe S, Baramy L, et al. Analysis of Medical Emergency Teams calls comparing subjective to “objective” call criteria. Resuscitation. 2009;80(1):44–49
  8. Cretikos M, Chen J, Hillman K, Bellomo R, Finfer S, Flabouris A. The objective medical emergency team activation criteria: a case-control study. Resuscitation. 2007;73(1):62–72
  9. Bellomo R, Goldsmith D, Uchino S, Buckmaster J, Hart GK, Opdam H, et al. A prospective before-and-after trial of a medical emergency team. Med J Aust. 2003;179(6):283–287
  10. Parr MJA, Hadfield JH, Flabouris A, Bishop G, Hillman K. The medical emergency team: 12 months analysis of reasons for activation, immediate outcomes and not for resuscitation orders. Resuscitation. 2001;50(1):39–44
  11. Institute for Clinical Systems Improvement Health Care Protocol: Rapid Response Team. 2nd ed. Available from http://www.icsi.org/.
  12. Ryan H, Cadman C, Hann L. Setting standards for assessment of ward patients at risk of deterioration. Br J Nurs. 2004;13(20):1186–1190
  13. Lee A, Bishop G, Hillman KM, Daffurn K. The medical emergency team. Anaesth Intens Care. 1995;23:183–186
  14. Andrews T, Waterman H. Packaging: a grounded theory of how to report physiological deterioration effectively. J Adv Nurs. 2005;52(5):473–481
  15. Cioffi J. Recognition of patients who require emergency assistance: a descriptive study. Heart Lung. 2000;29(4):262–268
  16. Cioffi J, Conway R, Everist L, Scott J, Senior J. ‘Patients of concern’ to nurses in acute care settings: a descriptive study. Aust Crit Care. 2009;22(4):178–186
  17. Harrison GA, Jacques TC, Kilborn G, McLaws M. The prevalence of recordings of the signs of critical conditions and emergency responses in hospital wards – the SOCCER study. Resuscitation. 2005;65(2):149–157
  18. Grossman SC, Wheeler K. Predicting patients’ deterioration and recovery. Clin Nurs Res. 1997;6(1):45–58
  19. Smith SK. An analysis of the phenomenon of deterioration in the critically ill. Image: J Nurs Scholarship. 1988;20(1):12–15
  20. Pyles SH, Stern PN. Discovery of nursing gestalt in critical care nursing: the importance of the gray gorilla syndrome. Image: J Nurs Scholarship. 1983;15(2):51–57
  21. Bausell RB. A practical guide to conducting empirical research. New York: Harper and Row; 1986;
  22. Lynn MR. Determination and quantification of content validity. Nurs Res. 1986;35(6):382–385
  23. Salant P, Dillman A. How to conduct your own survey. New York: John Wiley & Sons; 1994;
  24. Cummings SM, Savitz LA, Konrad TR. Reported response rates to mailed physician questionnaires. HSR: Health Services Research. 2001;35(6):1347–1355
  25. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatric Res. 1975;12:189–198
  26. Teasdale G, Jennett B. Assessment of coma and impaired consciousness: a practical scale. Lancet. 1974;2(7872):81–84
  27. Croskerry P. The theory and practice of clinical decision making. Can J Anesth. 2005;52(Supplement 1):R1–R8

PII: S1036-7314(10)00078-0

doi: 10.1016/j.aucc.2010.04.002

Australian Critical Care
Volume 23, Issue 4 , Pages 188-196 , November 2010