Recognising and responding to deteriorating patients: a matter of life or death

The most recent update of the Australian Institute of Health and Welfare’s (AIHW) Deaths in Australia report shows that in 2017 there were a total of 160,909 recorded deaths in Australia. 50% of these were found to be potentially avoidable within the current healthcare system among people aged younger than 75.

The most recent update of the Australian Institute of Health and Welfare’s (AIHW) Deaths in Australia report shows that in 2017 there were a total of 160,909 recorded deaths in Australia. 50% of these were found to be potentially avoidable within the current healthcare system among people aged younger than 75. 

Often there is a period prior to deterioration when it is clear the patient’s condition is worsening. Nurses working in acute hospital wards are essential in the process of recognising and responding to clinical deterioration in patients. Many nurses report being able to anticipate deterioration occurring but lack the support of colleagues and organisational structures to effectively intervene in a timely manner. 

How nurses anticipate and manage deterioration prior to the patient fulfilling rapid response system criteria is crucial. Regular education and training can empower all nursing staff to expand their clinical judgement of the deteriorating patient. In response to the National Safety and Quality Health Service (NSQHS) Standards several states’ public health organisations have implemented foundational education programs for clinicians. These programs include DETECT in NSW, COMPASS in ACT and OPTIMUS Core in QLD. Many Australian hospitals have also integrated Medical Emergency Teams (MET) into their organisational structures with almost 60% of hospitals that have an Intensive Care Unit (ICU) having a dedicated MET to escalate care (1). 

Early recognition programs that educate and empower nursing staff to recognise and escalate clinical deterioration appropriate are an important part of organisational structures to safeguard the well-being of vulnerable patients. The revised Standard 8 (Recognising and Responding to Acute Deterioration Standard) builds upon the previous Standard 9, with a focus on ensuring the appropriate education and organisational structures are implemented to detect early deterioration. Recent research into the impact of the initial Standard 9 (now Standard 8) has a positive impact on the care for deteriorating patients in their hospitals. 

The fact that patients can become very rapidly unwell is a high risk for them as well as the healthcare team. Our Recognising and Responding to Clinical Deterioration course builds and expands upon foundational deteriorating patient programs and provides essential skills relating to the assessment and management of patients experiencing or with the potential to experience clinical deterioration.

Critical Care Courses

If you would like to be part of the move to improve patient safety and outcomes by expanding your knowledge on the recognition and management for acute care patients, join us for our two-day course Recognising and Responding to Clinical Deterioration in a major city near you.

CPD Points

Nurses attending this program earn 12 CPD Hours towards their ongoing education.

(1) Jones D, George C, Hart GK, Bellomo R, Martin J. Introduction of medical emergency teams in Australia and New Zealand: a multi-Centre study. Crit Care. 2008;12:R46.

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Ken Hambrecht

Ken is the Founder and Principal Consultant for Critical Care Education Services (part of the Medcast Group).
Ph: 1300 898 973 www.criticalcare.edu.au

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