A new Situation Awareness model decrease clinical deterioration in the emergency departments – a controlled intervention study

Use of paediatric early warning scores in intermediate care units

Archives of Disease in Childhood ◽

10.1136/archdischild-2019-317055 ◽

2019 ◽

pp. archdischild-2019-317055

Author(s):

Marie Emilie Lampin ◽

Alain Duhamel ◽

Hélène Behal ◽

Morgan Recher ◽

Francis Leclerc ◽

...

Keyword(s):

Early Warning ◽

Emergency Departments ◽

Repeated Measures ◽

Medical Intervention ◽

Clinical Deterioration ◽

Early Warning Score ◽

Receiver Operating Curve ◽

Intermediate Care ◽

Derivation Cohort ◽

Early Warning Scores

ObjectivePaediatric early warning scores (EWS) were developed to detect deterioration in paediatric wards or emergency departments. The aim of this study was to assess the relationship between three paediatric EWS and clinical deterioration detected by the nurse in paediatric intermediate care units (PImCU).MethodsThis was a prospective, observational, multicentre study at seven French regional hospitals that included all children <18 years of age. Clinical parameters included in three EWS (Paediatric Advanced Warning Score, Paediatric Early Warning Score and Bedside Paediatric Early Warning System) were prospectively recorded every 8 hours or in case of deterioration. The outcome was a call to physician by the nurse when a clinical deterioration was observed. The cohort was divided into derivation and validation cohorts. An updated methodology for repeated measures was used and discrimination was estimated by the area under the receiver-operating curve.ResultsA total of 2636 children were included for 14 708 observations to compute a posteriori the EWS. The discrimination of the three EWS for predicting calls to physicians by nurses was good (range: 0.87–0.91) for the derivation cohort and moderate (range: 0.71–0.76) for the validation cohort. Equations for probability thresholds of calls to physicians, taking into account the time t, the score at time t and the score at admission, are available.ConclusionThese three EWS developed for children in paediatric wards or emergency departments can be used in PImCU to detect a clinical deterioration and predict the need for medical intervention.

Download Full-text

Systems for recognition and response to clinical deterioration in Victorian emergency departments

Australasian Emergency Care ◽

10.1016/j.auec.2017.12.003 ◽

2018 ◽

Vol 21 (1) ◽

pp. 3-7

Author(s):

Julie Considine ◽

Kerryn Rhodes ◽

Daryl Jones ◽

Judy Currey

Keyword(s):

Emergency Departments ◽

Clinical Deterioration ◽

Recognition And Response

Download Full-text

20 Optimizing inpatient situation awareness to recognize and mitigate clinical deterioration in hospitalized children

10.1136/bmjoq-2020-ihi.20 ◽

2020 ◽

Author(s):

Tina Sosa ◽

Maya Dewan ◽

Michelle Coleman ◽

Brandy Seger ◽

Jackie Hausfeld ◽

...

Keyword(s):

Situation Awareness ◽

Clinical Deterioration ◽

Hospitalized Children

Download Full-text

Clinical deterioration and perception of cues among medical surgical nurses

10.32469/10355/66197 ◽

2018 ◽

Author(s):

◽

Sabrina B. Orique

Keyword(s):

Signal Detection ◽

Situation Awareness ◽

Vital Signs ◽

Individual Characteristics ◽

Clinical Deterioration ◽

Future Research ◽

Skills Acquisition ◽

Failure To Rescue ◽

Cross Sectional ◽

Surgical Nurses

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] In the medical-surgical setting, failure to rescue events continue to remain prevalent. While failure to rescue events are often proceeded by changes in patient cues (i.e. vital signs), prior research suggests that both subtle and overt patient cues are sometimes missed or misinterpreted. Prompt recognition and management of failure to rescue events is dependent on nurses' capacity and tendency to perceive changes in patient cues that indicate clinical deterioration. To better understand the cognitive nature of medical-surgical nurses' deterioration cue perception, a cross-sectional non-experimental study was conducted. The Situation Awareness Model and Signal Detection Theory were used as a framework to examine nurses' capacity to perceive deterioration cues and associated nurse characteristics. Findings showed that as nurses' capacity to perceive deterioration cues increased, nurses were more likely to classify patient cues as indicators of deterioration. Though fatigue, education, and certification were not predictors of nurses' capacity to perceive deterioration cues, experience was observed to be a predictor based on levels of skills acquisition. Future research should aim to examine whether other individual characteristics such as information processing mechanisms and signal detection training affect nurses' ability to perceive deterioration cues.

Download Full-text

Consensus on predictors of clinical deterioration in emergency departments: A Delphi process study

Acta Anaesthesiologica Scandinavica ◽

10.1111/aas.13709 ◽

2020 ◽

Author(s):

Gitte Boier Tygesen ◽

Hans Kirkegaard ◽

Nikolaj Raaber ◽

Mette Trøllund Rask ◽

Marianne Lisby

Keyword(s):

Emergency Departments ◽

Delphi Process ◽

Clinical Deterioration ◽

Process Study

Download Full-text

Battlespace Terrain Ownership: A New Situation Awareness Tool

10.21236/ada460917 ◽

2005 ◽

Cited By ~ 1

Author(s):

Janet F. O'May ◽

Charles E. Hansen ◽

Eric G. Heilman ◽

Richard C. Kaste ◽

Andrew M. Neiderer

Keyword(s):

Situation Awareness ◽

Awareness Tool ◽

New Situation

Download Full-text

Improving Situation Awareness to Reduce Unrecognized Clinical Deterioration and Serious Safety Events

PEDIATRICS ◽

10.1542/peds.2012-1364 ◽

2012 ◽

Vol 131 (1) ◽

pp. e298-e308 ◽

Cited By ~ 98

Author(s):

P. W. Brady ◽

S. Muething ◽

U. Kotagal ◽

M. Ashby ◽

R. Gallagher ◽

...

Keyword(s):

Situation Awareness ◽

Clinical Deterioration

Download Full-text

Preventing Long-Term Reading Difficulties through Kindergarten and First Grade Intervention: The Case for Early Intervention

Perspectives on Language Learning and Education ◽

10.1044/lle15.1.22 ◽

2008 ◽

Vol 15 (1) ◽

pp. 22-33 ◽

Cited By ~ 4

Author(s):

Frank R. Vellutino ◽

Haiyan Zhang

Keyword(s):

Early Intervention ◽

Reading Disability ◽

Intervention Studies ◽

Intervention Study ◽

Reading Difficulties ◽

First Grade

Abstract This article reviews recent intervention studies that have provided the foundation for a variety of RTI approaches to reading disability classification and remediation. The three-tier model of RTI is defined and discussed. Selected findings from a kindergarten and first grade intervention study are summarized.

Download Full-text