Recognising and responding to clinical deterioration is paramount when practicing as a nurse in the Emergency Department.

Recognising and responding to clinical deterioration requires nurses to have specific knowledge and skills to recognise the urgency of a patient situation and respond appropriately.

This skill set includes identifying and interpreting signs and symptoms, abnormal vital signs and initiating early interventions. Failure in recognising and responding to the deteriorating patient can result in serious adverse outcomes for the patient.

Resources within this module will provide you with interactive materials to assist learning and effectively manage a deteriorating patient.

The deteriorating patient
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Interactive video simulation. Highly recommended. Nominal fee of AUD15. Registration required to access content.

Australian Commission on Safety and Quality in Health Care
Recognising and Responding to Clinical Deterioration.

Australian Commission on Safety and Quality in Health Care
The National Consensus Statement.

Australian Resuscitation Council
Welcome to the home of the Australian Resuscitation Council.

National Institute for Health and Care Excellence
Acutely ill adults in hospital: recognising and responding to deterioration.

Recognising and Responding to Acute Deterioration
The Recognising and Responding to Acute Deterioration Standard aims to ensure that acute deterioration in a person’s physical, mental or cognitive condition is recognised promptly and appropriate action is taken.

Recognising acute deterioration
The health organisation has processes for clinicians to detect acute physiological deterioration.

Escalating care
The health service organisation has protocols that specify criteria for escalating care.

Responding to deterioration
Health service organisation processes for timely response, access or referral of care to patients whose condition is acutely deteriorating.

Recognising and responding to acute deterioration

Many patients who experience a deterioration of their condition often exhibit warning signs (including abnormal vital signs) in the hours prior to the event. Early recognition and response to acute deterioration may prevent adverse events and potentially deaths in the hospital system.

Dalton, M., Harrison, J., Malin, A., & Leavey, C. (2018). Factors that influence nurses’ assessment of patient acuity and response to acute deterioration. British Journal of Nursing, 27(4), 212-218. doi:10.12968/bjon.2018.27.4.212

Della Ratta, C. (2016). Challenging graduate nurses’ transition: Care of the deteriorating patient. Journal of Clinical Nursing, 25(19-20), 3036-3048. doi:10.1111/jocn.13358

Felton, M. (2012). Recognising signs and symptoms of patient deterioration. Emergency Nurse, 20(8), 23-27.

Gluyas, H. (2017). Errors in the nursing management of a deteriorating patient. Nursing Standard, 32(12), 41-50. doi:10.7748/ns.2017.e10874

Lambe, K., Currey, J., & Considine, J. (2016). Frequency of vital sign assessment and clinical deterioration in an Australian Emergency Department. Australasian Emergency Nursing Journal, 19(4), 217-222. doi:10.1016/j.aenj.2016.09.001

Massey, D., Chaboyer, W., & Anderson, V. (2017). What factors influence ward nurses’ recognition of and response to patient deterioration? an integrative review of the literature. Nursing Open, 4(1), 6-23. doi:10.1002/nop2.53

Mohammmed Iddrisu, S., Hutchinson, A. F., Sungkar, Y., & Considine, J. (2018). Nurses’ role in recognising and responding to clinical deterioration in surgical patients. Journal of Clinical Nursing, 27(9-10), 1920-1930. doi:10.1111/jocn.14331