AIMS: To identify factors that influence recognition and response to adult patient deterioration in acute hospitals. DESIGN: A mixed-studies systematic review. DATA SOURCES: CINAHL, Medline, and Web of Science were searched for relevant literature published between 2007 - 2018. REVIEW METHODS: Studies were critically appraised, data extracted and thematically analysed. RESULTS: Thirteen papers met the inclusion criteria. Three main themes were identified: (a) Knowledge and understanding of clinical deterioration; (b) Organizational factors; managing deterioration and staffing levels; and (c) Communication; inter-professional relationships and professional-patient communication. CONCLUSION: Despite national guidelines, the review findings suggest that the recognition and response to adult patient deterioration in acute hospital settings is sub-optimal. A multitude of factors influencing the recognition and response to adult patient deterioration emerged from the findings. IMPACT: Patients are receiving sub-optimal care due to failure in recognizing and responding to patient deterioration in an appropriate and timely manner. Nurses lack knowledge and understanding of deterioration. Organizational factors contribute to inadequate care and communication among professionals was highlighted as challenging. The factors that influence the recognizing and responding to patient deterioration in acute hospitals are multi-faceted, however this review highlights immediate recommendations for professionals in the acute care setting.
AIMS: To identify factors that influence recognition and response to adult patient deterioration in acute hospitals. DESIGN: A mixed-studies systematic review. DATA SOURCES: CINAHL, Medline, and Web of Science were searched for relevant literature published between 2007 - 2018. REVIEW METHODS: Studies were critically appraised, data extracted and thematically analysed. RESULTS: Thirteen papers met the inclusion criteria. Three main themes were identified: (a) Knowledge and understanding of clinical deterioration; (b) Organizational factors; managing deterioration and staffing levels; and (c) Communication; inter-professional relationships and professional-patient communication. CONCLUSION: Despite national guidelines, the review findings suggest that the recognition and response to adult patient deterioration in acute hospital settings is sub-optimal. A multitude of factors influencing the recognition and response to adult patient deterioration emerged from the findings. IMPACT: Patients are receiving sub-optimal care due to failure in recognizing and responding to patient deterioration in an appropriate and timely manner. Nurses lack knowledge and understanding of deterioration. Organizational factors contribute to inadequate care and communication among professionals was highlighted as challenging. The factors that influence the recognizing and responding to patient deterioration in acute hospitals are multi-faceted, however this review highlights immediate recommendations for professionals in the acute care setting.