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Journal Article > Study
Inattentional blindness and failures to rescue the deteriorating patient in critical care, emergency and perioperative settings: four case scenarios.
Jones A, Johnstone MJ. Aust Crit Care. 2017;30:219-223.
This qualitative study combined the narratives of various critical care nurses into four representative scenarios demonstrating failure to recognize clinically deteriorating patients. The authors describe inattentional blindness, a concept in which individuals in high-complexity environments can miss an important event because of competing attentional tasks, as a key factor in these failure-to-rescue events.
Journal Article > Study
Chalwin R, Giles L, Salter A, Eaton V, Kapitola K, Karnon J. Jt Comm Qual Patient Saf. 2019;45:268–275.
Rapid response teams remain a well-established patient safety strategy and are frequently implemented in order to identify deteriorating patients early so that appropriate care can be provided quickly. However, evidence supporting their effectiveness remains mixed. In this retrospective study, researchers found that patients who triggered a rapid response call but who met ongoing rapid response criteria when the initial call ended and then triggered a repeat call had significantly higher odds of mortality compared to patients with a single rapid response call during their admission.
Journal Article > Review
How do nurses use early warning scoring systems to detect and act on patient deterioration to ensure patient safety? A scoping review.
Wood C, Chaboyer W, Carr P. Int J Nurs Stud. 2019;94:166-178.
Early detection of patient deterioration remains an elusive patient safety target. This scoping review examined how nurses employ early warning scoring systems that prompt them to call rapid response teams. Investigators identified 23 studies for inclusion. Barriers to effective identification and treatment of patient deterioration included difficulty implementing early warning score systems, overreliance on numeric risk scores, and inconsistent activation of rapid response teams based on early warning score results. They recommend that nurses follow scoring algorithms that calculate risk for deterioration while supplementing risk scoring with their clinical judgment from the bedside. A WebM&M commentary highlighted how early recognition of patient deterioration requires not only medical expertise but also collaboration and communication among providers.