The early signs of deterioration include changes in respiratory rate, oxygen saturation, blood pressure, heart rate, temperature and conscious/mental status which may go unrecognised.
Heart Rate & Respiratory rate are leading indicators of patient deterioration. To help detect deterioration early, accurate capture of vital signs including heart rate & respiratory rate is critical.
The approach to all deteriorating or critically ill patients is the same. The underlying principles are: Use the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach to assess and treat the patient. Do a complete initial assessment and re-assess regularly.
There are six initial nursing actions that should be taken when responding to clinical deterioration. These include A-Call for Help, B-Collect More Data, C-Patient Positioning, D-Oxygen Therapy, E-Prepare for RRS/MET and F-Handover. Use the emergency call button in the patient's room to alert others that you need help.
Reported change • Distress • Loss of touch with reality or consequence of behaviours • Loss of function • Elevated risk to self, others or property. These five indicators provide an overarching framework for arranging the agreed signs for the purpose of monitoring deterioration in a person's mental state.
The Recognising and Responding to Acute Deterioration Standard aims to ensure that a person's acute deterioration is recognised promptly and appropriate action is taken. Acute deterioration includes physiological changes, as well as acute changes in cognition and mental state.
The early signs of deterioration include changes in respiratory rate, oxygen saturation, blood pressure, heart rate, temperature and conscious/mental status which may go unrecognised.
Respiratory rate
The most sensitive indicator of potential deterioration. Rising respiratory rate often early sign of deterioration. accessory muscles, increased work of breathing, able to speak?, exhaustion, colour of patient. Position of resident is important.
Signs of deterioration may include symptoms such as declining function, increasing fatigue, declining or fluctuating oral intake, declining or fluctuating conscious state, increasing pain, etc.
The three main degradation mechanisms considered are physical, chemical and biological mechanisms. Physical degradation factors discussed are temperature, relative humidity, ultraviolet and infrared light.
Early Warning Signs are the first signs and symptoms that suggest something isn't right. Early on they may come and go, or occur only at a low level.
Early Detection of Deterioration in Elderly or EDDIE is a program that aims to help nursing staff detect signs of deteriorating health in the elderly early and to provide subacute care in order to avoid hospitalisation. Early detection results in better outcomes for the client.
Stop and Watch is a tool that everyone can use to help spot the warning signs that a person's condition is deteriorating. By recognising these signs you can reduce a person's risk of morbidity, further disability, organ failure, or sometimes even death.
Patients at Risk of deterioration (PaR)
Those patients that trigger on an Early Warning System or whose condition causes concern to medical or nursing or midwifery staff.
Deterioration in a patient's clinical condition frequently occurs over several hours before a critical event, providing hospital staff with a potential window of opportunity for intervention if detection of signs and symptoms occurs early.
possible general indicators of deterioration are increasing care needs, choice for no further active care, increasing physical or mental health concerns. special condition-related clinical indicators.
Acute deterioration includes physiological, psychological and cognitive changes that indicate a worsening of the patient's health status, which may occur over hours or days. Communication is fundamental to the prompt identification, escalation and management of acute deterioration.
Early identification of clinical deterioration is important in preventing subsequent cardiopulmonary arrest and to reduce mortality, but sometimes patients' conditions deteriorate before nursing and medical staff recognise and respond to the signs.