Deteriorating Patient Case Studies

Participation was voluntary and consent was obtained from staff prior to their participation in each research activity.

A structured survey (Table 2 ), relating to confidence in vital signs monitoring tools and practices, was verbally administered to 33 nurses.

Yet, recent research shows that the monitoring and recording of the five vital signs is often incomplete which poses the potential to miss deterioration [ 9 ].

The patient casemix on general wards has changed over recent decades, with patients now older, more acutely ill, experiencing more co-morbidities and facing complex procedures [ 10–12 ].

Family members are a vital part of the healthcare team and are often best positioned to recognize the sometimes subtle, yet very important changes in their loved one's condition that may indicate deterioration.

You may not know WHAT is wrong, but you know something just isn't right.Early detection of patient deterioration and prevention of adverse events are key challenges to patient safety.This study investigated clinical staff perceptions of current monitoring practices and the planned introduction of continuous monitoring devices on general wards.Yet, general ward patients are still monitored in much the same way as they have for over a century: with nurses intermittently measuring and recording vital signs.Moreover, the frequency of recording varies, with limited evidence to suggest the most effective frequency for measurement [ 13 ].Nurses were confident about their abilities to identify patients at risk of deterioration, using a combination of vital signs and visual assessment.There were concerns about the accuracy of current vital signs monitoring equipment and frequency of intermittent observation.Continuous monitoring technologies are a more proactive approach to the early detection of patient deterioration and have been reported as potentially enhancing early identification of deteriorating patients [ 14 ].There is limited research, however, that assesses clinical staff perceptions regarding patient monitoring and the potential impact of continuous monitoring on practices.Thus, 36 respiratory ward and 38 neurosurgery ward nurses (total 74 nurses) were eligible to participate in the knowledge survey.Prior to commencing the research, we held briefing sessions for staff to explain the study purpose and provide a demonstration of the continuous monitoring devices.


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