Dr Ron Daniels BEM, chief executive of the UK Sepsis Trust, provides his thoughts on the importance of standardising the national track and trigger systems across primary and secondary care to improve early detection in the deterioration of patients.
Standardising the process of monitoring patients to quickly and effectively detect deterioration, is a problem faced by healthcare professionals across the UK. With staffing issues, inter-observer discrepancies and transcription error there are many variables that impact on patient assessments which can subsequently lead to poor outcomes. Studies show that respiratory rate (RR) changes 6-8 hours before a major event. By using a standardised track and trigger process such as NEWS2 to identify a change in accurate RR earlier, the patient data can be mapped and patient outcome could be improved.
The infrequent nature of observations due to staffing levels is a major problematic factor in the monitoring of patients. Typically taken by non-nursing staff, such as healthcare assistants, current guidelines recommend that patient observations are conducted every 12 hours as a minimum frequency.
However, it is widely acknowledged that this ‘12-hour wait’ could be too long a period to effectively detect and manage patient deterioration. Inter-observer variability also impacts readings – successfully making a note of an observation requires the close attention of the healthcare professional to the patient. However, this is rarely possible.
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