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Systems for recognition and response to deteriorating emergency department patients: a scoping review

Considine, Julie, Fry, Margaret, Curtis, Kate and Shaban, Ramon Z. 2021, Systems for recognition and response to deteriorating emergency department patients: a scoping review, Scandinavian journal of trauma, resuscitation and emergency Medicine, vol. 29, pp. 1-10, doi: 10.1186/s13049-021-00882-6.

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Title Systems for recognition and response to deteriorating emergency department patients: a scoping review
Author(s) Considine, JulieORCID iD for Considine, Julie orcid.org/0000-0003-3801-2456
Fry, Margaret
Curtis, Kate
Shaban, Ramon Z.
Journal name Scandinavian journal of trauma, resuscitation and emergency Medicine
Volume number 29
Article ID 69
Start page 1
End page 10
Total pages 10
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2021
ISSN 1757-7241
1757-7241
Keyword(s) ADMISSION
Clinical deterioration
CLINICAL-RESEARCH PRIORITIES
COVID-19 PATIENTS
Deteriorating patients
EARLY WARNING SCORE
Emergency department
Emergency medicine
Emergency nursing
FREQUENCY
IN-HOSPITAL MORTALITY
INTENSIVE-CARE
Life Sciences & Biomedicine
NEWS
Patient safety
PREDICTIVE-VALUE
Rapid response team
Science & Technology
Scoping review
SURVIVAL
Summary Background
Assessing and managing the risk of clinical deterioration is a cornerstone of emergency care, commencing at triage and continuing throughout the emergency department (ED) care. The aim of this scoping review was to assess the extent, range and nature of published research related to formal systems for recognising and responding to clinical deterioration in emergency department (ED) patients.
Materials and methods
We conducted a scoping review according to PRISMA-ScR guidelines. MEDLINE complete, CINAHL and Embase were searched on 07 April 2021 from their dates of inception. Human studies evaluating formal systems for recognising and responding to clinical deterioration occurring after triage that were published in English were included. Formal systems for recognising and responding to clinical deterioration were defined as: i) predefined patient assessment criteria for clinical deterioration (single trigger or aggregate score), and, or ii) a predefined, expected response should a patient fulfil the criteria for clinical deterioration. Studies of short stay units and observation wards; deterioration during the triage process; system or score development or validation; and systems requiring pathology test results were excluded. The following characteristics of each study were extracted: author(s), year, design, country, aims, population, system tested, outcomes examined, and major findings.
Results
After removal of duplicates, there were 2696 publications. Of these 33 studies representing 109,066 patients were included: all were observational studies. Twenty-two aggregate scoring systems were evaluated in 29 studies and three single trigger systems were evaluated in four studies. There were three major findings: i) few studies reported the use of systems for recognising and responding to clinical deterioration to improve care of patients whilst in the ED; ii) the systems for recognising clinical deterioration in ED patients were highly variable and iii) few studies reported on the ED response to patients identified as deteriorating.
Conclusion
There is a need to re-focus the research related to use of systems for recognition and response to deteriorating patients from predicting various post-ED events to their real-time use to improve patient safety during ED care.
Language eng
DOI 10.1186/s13049-021-00882-6
Indigenous content off
Field of Research 1103 Clinical Sciences
1110 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30151819

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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.