Patient perceptions of deterioration and patient and family activated escalation systems-a qualitative study Guinane, Jessica, Hutchinson, Alison M and Bucknall, Tracey K 2018, Patient perceptions of deterioration and patient and family activated escalation systems-a qualitative study, Journal of clinical nursing, vol. 27, no. 7-8, pp. 1621-1631, doi: 10.1111/jocn.14202. Attached Files Name Description MIMEType Size Downloads bucknall-patientperceptions-2018.pdf Published version application/pdf 903.48KB 124 Title Patient perceptions of deterioration and patient and family activated escalation systems-a qualitative study Author(s) Guinane, Jessica Hutchinson, Alison M orcid.org/0000-0001-5065-2726 Bucknall, Tracey K orcid.org/0000-0001-9089-3583 Journal name Journal of clinical nursing Volume number 27 Issue number 7-8 Start page 1621 End page 1631 Total pages 11 Publisher Wiley-Blackwell Publishing Place of publication Chichester, Eng. Publication date 2018-04 ISSN 0962-1067 1365-2702 Keyword(s) clinical decision-making communication deterioration nursing patient and family escalation patient participation rapid response systems Summary Aims and objectives To investigate the experiences of patients who received a medical emergency team review following a period of clinical deterioration and their views about the potential use of a patient and family activated escalation system. Background Delay or failure by health professionals to respond to clinical deterioration remains a patient safety concern. Patients may sometimes identify subtle cues of early deterioration prior to changes in vital signs. In response to health professional and system failures, patient and family activated escalation systems have been mandated and implemented in Australia. However, little research has evaluated their effectiveness nor taken patients’ perspectives into account. Design Qualitative exploratory descriptive design was used. Methods Purposive sampling was used. Semistructured interviews were undertaken in 2014 with 33 patients who required medical emergency team intervention. Data were collected from one private and one public hospital in Melbourne, Victoria, Australia. The framework method was used to analyse the data. Results All patients stated that it was the clinician who detected and responded to deterioration. Private patient participants were unaware of the medical emergency team system, and felt escalating care was not their responsibility. These patients reported being too sick to communicate prior to and during medical emergency team review and did not favour a patient and family activated escalation system. Public patients were well informed about the medical emergency team system yet expressed concerns around overriding clinicians if activating a patient and family activated escalation system. Conclusion Patient participation during a period of deterioration is restricted by their clinical condition and limited medical knowledge. Patients felt comfortable to communicate concerns to clinicians but felt they would not activate the patient and family activated escalation system. This behoves clinicians to actively listen and respond to patient concerns. Language eng DOI 10.1111/jocn.14202 Field of Research 1110 Nursing 1701 Psychology HERDC Research category C1.1 Refereed article in a scholarly journal ERA Research output type C Journal article Copyright notice ©2017, The Authors Free to Read? Yes Use Rights Persistent URL http://hdl.handle.net/10536/DRO/DU:30108793 Document type: Journal Article Collections: Faculty of Health Centre for Quality and Patient Safety Research Open Access Collection Related Links Link Description Connect to published version (open access) Go to link with your DU access privileges     Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved. Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au. Versions Version Filter Type Wed, 30 May 2018, 15:48:25 EST Wed, 30 May 2018, 15:49:04 EST Thu, 31 May 2018, 05:00:56 EST Thu, 31 May 2018, 06:05:19 EST Thu, 31 May 2018, 10:52:14 EST Thu, 31 May 2018, 10:52:51 EST Tue, 12 Jun 2018, 10:34:44 EST Fri, 07 Sep 2018, 18:28:09 EST Filtered Full Citation counts:   Cited 3 times in TR Web of Science Cited 3 times in Scopus Search Google Scholar Access Statistics: 176 Abstract Views, 126 File Downloads  -  Detailed Statistics Created: Wed, 30 May 2018, 15:49:04 EST

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.