The role of the ward nurse in recognition and response to clinical deterioration: a scoping review

Abstract

Background: Nurses play a key role in the recognition and response to clinical deterioration. Aim: The aim of this scoping review was to explore, map and synthesise existing research related to the ward nurses’ role in recognising and responding to clinical deterioration. Methods: A scoping review was undertaken to identify English only studies focused on the ward nurse’s role in recognition and response to clinical deterioration of the hospitalised adult. Search terms included ‘clinical deterioration’, ‘nurses’, ‘wards’, ‘general’, ‘hospital, units’ and ‘hospitals’. The Cumulative Index to Nursing and Allied Health Literature, EMBASE, Ovid MEDLINE, PubMed, ProQuest and Science Direct databases were searched for eligible studies. Results: Forty-six studies met the inclusion criteria and three major themes were synthesised: (i) recognition of deterioration; (ii) nursing assessment; and, (iii) challenges responding to patient deterioration. Conclusion: The review highlighted significant variability in the ward nurses’ role, activities, and skills in assessing, monitoring, managing and escalating care for clinical deterioration.