There are unique challenges in recognising and responding to clinical deterioration(RRCD) in sub-acute settings as they are often geographically separate from tertiary facilities and have different resources to manage clinical deterioration. Nurses play a lead role in RRCD, yet, limited understanding of nurses’ knowledge and perceptions of RRCD in a subacute care setting. This study investigated what factors influence nursing staff’s recognition and response to, clinical deterioration in a sub-acute care setting with major older adult demographics.
An explanatory mixed methods design was conducted in two phases at a subacute public metropolitan hospital in Western Australia.
Phase one - a retrospective review of hospital administrative data to identify the patient cohort admitted to the subacute hospital; a review of clinical records to evaluate the recognition and response to clinical deterioration of patients over a six-month period; and a survey of nurses’ and assistant in nurses’ knowledge and perceptions of RRCD.
Phase two-individual interviews to explore nurses’ experiences of the RRCD.
Survey data underwent descriptive statistical analysis using SPSS and qualitative data from open-ended survey questions underwent content analysis.
Seventy-two nurses responded to the survey. Key findings were: 81%agreed the medical emergency team(MET) is effective in managing clinical deterioration; 91%agreed they will call the MET for patient deterioration, and 82.2%agreed MET communicates effectively. Content analysis identified the importance of MET for clinical deterioration, lack of knowledge of the policy, clinical decision making informed by policy, fear to escalate, and many more.
The results may identify education needs of nurses in RRCD.