Introduction
Noticeable indications of deterioration have been shown in numerous patients few hours prior to a critical condition (Ludikhuize, Smorenburg, de Rooij, & de Jonge, 2012). Critical condition can be prevented by recognizing and responding to early indications of clinical and physiological deterioration (kyriacosu, jelsma,& jordan (2011). According to NPSA (2007) delay in responding to deteriorating vital signs have been defined as an complication resulting in prolonged length of stay, disability or death, not attributed to the patient's underlying illness procedure along but by their health-care management ( Baba-Akbari Sari, Sheldon, Carcknell, & Turnbull. 2006; Helling, Martin, Martin, & Mitchell, 2014). A number of studies demonstrate …show more content…
2010). Track and trigger systems assist clinicians to understand when and how to respond to deterioration (ACSQHC, 2010; ACSQHC, 2011; ACSQHC, 2012). Repeated recording of vital signs “tracks” the patient and “triggers” a “response” when a predetermined threshold is reached. The simplest systems require only a single parameter to be reached (McNeill et al. 2011), while more complex systems assign an aggregated score (eg, an early warning score) and trigger predefined, often graded, calling criteria (Donohue, L. A., & Endacott, R. (2010). The result triggered can fluctuate from a legal document increase in the frequency of observations to a call for review by a medical emergency team, critical care outreach service or senior clinician. Track and trigger response framework can provide a tracking mechanism throughout a patient’s hospital journey, and are designed to flag deterioration after initial assessment (Paul et al, 2011). Once a nurse recognises a patient is deteriorating they play a critical role in terms of response. Nurses who identify a deteriorating patient must escalate the patient care in-line with their hospital’s policies including initiating a clinical review or a MET …show more content…
Singh’s neurological function. This assessment must consider his presenting conditions of increasing confusion and decreasing mobility. The assessment may cover: Glasgow Comma Score (GCS); pain; pupil response; limb movement and strength; temperature; and blood glucose (Thim et al., 2012). Mr. Singh has a GCS of 13/15. This is a drop of two from his usual GCS which does not trigger escalation under assessment (a fall of more than two would trigger a MET Call). However it is not clear which categories the drop in GCS occurred (eye opening, verbal response or motor response (Marmarou et al., 2007)). If the drop in GCS includes a change in conscious state from previously alert to now only responsive to verbal stimuli, escalation would be required under assessment for conscious state (a previously alter patent now only responsive to verbal stimuli). Mr. Singh has a temperature of 38.5°C. This is higher than the normal range for adults of 36 to 37.5°C (McCallum & Higgins, 2012) and triggers a clinical review under assessment. Mr. Singh has lower abdominal pain of 4/10. This level of pain would not trigger escalation under assessment however will provide useful information for the clinical review. Mr. Singh has a blood glucose of 13.2 mmol/L which indicates he is hyperglycaemic (Thim et al., 2012). This reading will provide useful information for the clinical review. The nurse would recognise Mr. Singh as requiring clinical review for
Noticeable indications of deterioration have been shown in numerous patients few hours prior to a critical condition (Ludikhuize, Smorenburg, de Rooij, & de Jonge, 2012). Critical condition can be prevented by recognizing and responding to early indications of clinical and physiological deterioration (kyriacosu, jelsma,& jordan (2011). According to NPSA (2007) delay in responding to deteriorating vital signs have been defined as an complication resulting in prolonged length of stay, disability or death, not attributed to the patient's underlying illness procedure along but by their health-care management ( Baba-Akbari Sari, Sheldon, Carcknell, & Turnbull. 2006; Helling, Martin, Martin, & Mitchell, 2014). A number of studies demonstrate …show more content…
2010). Track and trigger systems assist clinicians to understand when and how to respond to deterioration (ACSQHC, 2010; ACSQHC, 2011; ACSQHC, 2012). Repeated recording of vital signs “tracks” the patient and “triggers” a “response” when a predetermined threshold is reached. The simplest systems require only a single parameter to be reached (McNeill et al. 2011), while more complex systems assign an aggregated score (eg, an early warning score) and trigger predefined, often graded, calling criteria (Donohue, L. A., & Endacott, R. (2010). The result triggered can fluctuate from a legal document increase in the frequency of observations to a call for review by a medical emergency team, critical care outreach service or senior clinician. Track and trigger response framework can provide a tracking mechanism throughout a patient’s hospital journey, and are designed to flag deterioration after initial assessment (Paul et al, 2011). Once a nurse recognises a patient is deteriorating they play a critical role in terms of response. Nurses who identify a deteriorating patient must escalate the patient care in-line with their hospital’s policies including initiating a clinical review or a MET …show more content…
Singh’s neurological function. This assessment must consider his presenting conditions of increasing confusion and decreasing mobility. The assessment may cover: Glasgow Comma Score (GCS); pain; pupil response; limb movement and strength; temperature; and blood glucose (Thim et al., 2012). Mr. Singh has a GCS of 13/15. This is a drop of two from his usual GCS which does not trigger escalation under assessment (a fall of more than two would trigger a MET Call). However it is not clear which categories the drop in GCS occurred (eye opening, verbal response or motor response (Marmarou et al., 2007)). If the drop in GCS includes a change in conscious state from previously alert to now only responsive to verbal stimuli, escalation would be required under assessment for conscious state (a previously alter patent now only responsive to verbal stimuli). Mr. Singh has a temperature of 38.5°C. This is higher than the normal range for adults of 36 to 37.5°C (McCallum & Higgins, 2012) and triggers a clinical review under assessment. Mr. Singh has lower abdominal pain of 4/10. This level of pain would not trigger escalation under assessment however will provide useful information for the clinical review. Mr. Singh has a blood glucose of 13.2 mmol/L which indicates he is hyperglycaemic (Thim et al., 2012). This reading will provide useful information for the clinical review. The nurse would recognise Mr. Singh as requiring clinical review for