Nurses’ worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals: a systematic review
Nurses’ worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals: a systematic review
INTRODUCTION:Nurses often recognize deterioration in patients through intuition rather than through routine measurement of vital signs. Adding the 'worry or concern' sign to the Rapid Response System provides opportunities for nurses to act upon their intuitive feelings. Identifying what triggers nurses to be worried or concerned might help to put intuition into words, and potentially empower nurses to act upon their intuitive feelings and obtain medical assistance in an early stage of deterioration. The aim of this systematic review is to identify the signs and symptoms that trigger nurses' worry or concern about a patient's condition.
METHODS:We searched the databases PubMed, CINAHL, Psychinfo and Cochrane Library (Clinical Trials) using synonyms related to the three concepts: 'nurses', 'worry/concern' and 'deterioration'. We included studies concerning adult patients on general wards in acute care hospitals. The search was performed from the start of the databases until 14 February 2014.
RESULTS:The search resulted in 4,006 records, and 18 studies (five quantitative, nine qualitative and four mixed-methods designs) were included in the review. A total of 37 signs and symptoms reflecting the nature of the criterion worry or concern emerged from the data and were summarized in 10 general indicators. The results showed that worry or concern can be present with or without change in vital signs.
CONCLUSIONS:The signs and symptoms we found in the literature reflect the nature of nurses' worry or concern, and nurses may incorporate these signs in their assessment of the patient and their decision to call for assistance. The fact that it is present before changes in vital signs suggests potential for improving care in an early stage of deterioration.
Douw, Gooske
94b773e5-5b74-4cb0-997f-db7a010243d3
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Holwerda, Tineke
736577f1-280d-404f-ac90-618167c1687a
Huisman-de Waal, Getty
2ff64e2d-fa02-4e09-9aed-6e9140ebe3ef
van Zanten, Arthur R.H.
d73e8329-40a8-463b-b9c3-9529414fca22
van Achterberg, Theo
eb49404e-62c6-427d-bb94-580254177a30
van der Hoeven, Johannes G.
78ca86cf-76cd-4578-b063-649414423b43
20 May 2015
Douw, Gooske
94b773e5-5b74-4cb0-997f-db7a010243d3
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Holwerda, Tineke
736577f1-280d-404f-ac90-618167c1687a
Huisman-de Waal, Getty
2ff64e2d-fa02-4e09-9aed-6e9140ebe3ef
van Zanten, Arthur R.H.
d73e8329-40a8-463b-b9c3-9529414fca22
van Achterberg, Theo
eb49404e-62c6-427d-bb94-580254177a30
van der Hoeven, Johannes G.
78ca86cf-76cd-4578-b063-649414423b43
Douw, Gooske, Schoonhoven, Lisette, Holwerda, Tineke, Huisman-de Waal, Getty, van Zanten, Arthur R.H., van Achterberg, Theo and van der Hoeven, Johannes G.
(2015)
Nurses’ worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals: a systematic review.
Critical Care, 19 (1), [230].
(doi:10.1186/s13054-015-0950-5).
(PMID:25990249)
Abstract
INTRODUCTION:Nurses often recognize deterioration in patients through intuition rather than through routine measurement of vital signs. Adding the 'worry or concern' sign to the Rapid Response System provides opportunities for nurses to act upon their intuitive feelings. Identifying what triggers nurses to be worried or concerned might help to put intuition into words, and potentially empower nurses to act upon their intuitive feelings and obtain medical assistance in an early stage of deterioration. The aim of this systematic review is to identify the signs and symptoms that trigger nurses' worry or concern about a patient's condition.
METHODS:We searched the databases PubMed, CINAHL, Psychinfo and Cochrane Library (Clinical Trials) using synonyms related to the three concepts: 'nurses', 'worry/concern' and 'deterioration'. We included studies concerning adult patients on general wards in acute care hospitals. The search was performed from the start of the databases until 14 February 2014.
RESULTS:The search resulted in 4,006 records, and 18 studies (five quantitative, nine qualitative and four mixed-methods designs) were included in the review. A total of 37 signs and symptoms reflecting the nature of the criterion worry or concern emerged from the data and were summarized in 10 general indicators. The results showed that worry or concern can be present with or without change in vital signs.
CONCLUSIONS:The signs and symptoms we found in the literature reflect the nature of nurses' worry or concern, and nurses may incorporate these signs in their assessment of the patient and their decision to call for assistance. The fact that it is present before changes in vital signs suggests potential for improving care in an early stage of deterioration.
Text
Nurses worry or concern and early recognition of deteriorating patients on general wards in acute hospitals.pdf
- Version of Record
More information
Accepted/In Press date: 11 May 2015
Published date: 20 May 2015
Organisations:
Faculty of Health Sciences
Identifiers
Local EPrints ID: 388431
URI: http://eprints.soton.ac.uk/id/eprint/388431
ISSN: 1364-8535
PURE UUID: b1fa0d82-1bfc-4bf5-a5a8-ef48d4c4d06c
Catalogue record
Date deposited: 25 Feb 2016 15:02
Last modified: 15 Mar 2024 03:41
Export record
Altmetrics
Contributors
Author:
Gooske Douw
Author:
Tineke Holwerda
Author:
Getty Huisman-de Waal
Author:
Arthur R.H. van Zanten
Author:
Theo van Achterberg
Author:
Johannes G. van der Hoeven
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics
