Vital sign assessment and nursing interventions in medical and surgical patients with rapid response system triggers.
Julie Considine, Alison M Hutchinson, Imogen Mitchell and 4 others
PMID 37365897WHAT IT FOUND
Only 26.8% of audits with rapid response system triggers had a documented call to the rapid response team.
Vital signs were usually documented, and nurses documented interventions within their scope.
Key findings
01At least one vital sign was documented every 8 hours in 91.6% of audits, and a complete set was documented in 83.1% of audits.
02When rapid response system triggers were present, escalation of care per policy was documented in 26.8% of audits.
03Nursing interventions were documented more often when care was escalated per policy: 55.1% versus 24.0% for pre-MET triggers and 78.2% versus 57.0% for MET triggers.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The data came from medical records, so care may have been given or escalated without being documented. The same patients could be counted on multiple audit days, and results are at audit level rather than patient level. Small numbers of escalations and interventions limited some analyses. The study did not measure patient outcomes, so it cannot show whether interventions or escalation improved deterioration. Associations between triggers and escalation do not prove cause and effect.
Declared interests
Funded by the National Health and Medical Research Council and partner organisations: Alfred Health, Eastern Health, Monash Health, Australian Commission on Safety and Quality in Health Care and SA Health. The authors declared no conflicts of interest.
The easy way to misread this
Do not read the 26.8% escalation figure as proof that nurses did not escalate care. The audit counted only documented calls, and escalation may have occurred through another route without being recorded.