NDLI: Indicators of clinical deterioration in adult general ward patients from nurses’ perspectives: a mixed-methods systematic review

Content Provider	Springer Nature : BioMed Central
Author	Chung, Jeehae Jung, Hyesil
Abstract	Background Early recognition and response to deteriorating patients in general wards are core competencies for nurses. Clinical deterioration is a worsening condition that increases the risk of morbidity and mortality. Although objective measures are commonly used, recent research suggests that subjective data and nurses’ intuitions can serve as valuable indicators for early detection of deterioration in patients. This study aims to comprehensively identify and classify the indicators used to detect clinical deterioration in patients hospitalized in general wards from nurses’ perspectives. Methods This is a mixed-methods systematic review followed a Joanna Briggs Institute Methodology convergent integrated approach. Four electronic databases (PubMed, CINAHL, Embase, and Scopus) were searched. Studies were screened based on the population of interest (nurses), the phenomenon of interest (patient deterioration), the context (adult care in acute hospital settings), the study type (original studies), and publication in English peer-reviewed journals from January 2014 to December 2023. Two authors independently conducted all screening steps and assessed the methodological quality of the included studies. Any disagreements were resolved through discussion. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Results Twenty-one studies met the eligibility criteria. Key indicators included vital signs, intake and output, laboratory data, and observational data. Nurses also relied on subjective data from patients’ complaints and their own intuition to predict patient deterioration. The frequency and pattern of specific nursing interventions also play an important role. Conclusions This review identified vital indicators from nurses’ perspectives, underscoring the value of subjective observations, intuition, and specific nursing interventions in predicting patient deterioration. Integrating subjective factors with objective data can improve early recognition of and response to clinical deterioration, thereby enhancing patient safety and outcomes. This review provides a foundation for future research aimed at quantifying subjective elements, such as patient complaints and nurses’ intuitions, to be included in nursing records as key indicators for predicting patient deterioration. Trials registration This study was registered with PROSPERO under the registration number CRD42024552344.
Related Links	https://bmcnurs.biomedcentral.com/counter/pdf/10.1186/s12912-024-02531-6.pdf
Ending Page	17
Page Count	17
Starting Page	1
File Format	HTM / HTML
ISSN	14726955
DOI	10.1186/s12912-024-02531-6
Journal	BMC Nursing
Issue Number	1
Volume Number	23
Language	English
Publisher	BioMed Central
Publisher Date	2024-11-26
Access Restriction	Open
Subject Keyword	Nursing Nursing Management Nursing Research Clinical deterioration Early recognition Mixed-methods systematic review Nursing interventions Nurse intuition Subjective indicators Observational data
Content Type	Text
Resource Type	Article
Subject	Nursing
Journal Impact Factor	3.1/2023
5-Year Journal Impact Factor	3.5/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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