Journal Article

The fifth vital sign? Nurse worry predicts inpatient deterioration within 24 hours.

Romero-Brufau S, Gaines K, Nicolas CT, et al. JAMIA Open. 2019;2(4):465-470.

Early recognition of clinical deterioration, in order to promote rapid response, is a critical inpatient safety priority. This prospective observational study examined bedside nurses' perception of possible clinical deterioration as a predictor of subsequent clinical deterioration. Researchers scored nurse Worry Factor on a 5-point scale from 0 (no concern) to 4 (extreme concern). Higher concern for patient deterioration on the part of nurses was strongly associated with subsequent clinical deterioration and intensive care unit transfer. The authors conclude that nurse concern is a powerful predictor of deterioration and should be included in the electronic health record. A WebM&M commentary highlighted how early recognition of patient deterioration requires not only medical expertise but also collaboration and communication among providers.