ICU Trelawny Wing, Royal Cornwall Hospitals NHS Trust, Truro, Cornwall, UK.
Intensive Crit Care Nurs. 2010 Feb;26(1):10-7. doi: 10.1016/j.iccn.2009.10.006. Epub 2009 Dec 5.
The majority of hospitals in the United Kingdom (UK) use some form of track and trigger scoring system, such as early warning scores, to identify deteriorating patients; however, response by the multi-professional team is not always timely and problems with recognition of deterioration persist.
To examine ward nurse and critical care outreach staff perceptions of the management of patients who deteriorate in acute wards.
A qualitative design was used with critical incident (CI) technique employed to structure data collection. Semi-structured interviews were undertaken with nurses who had managed a patient who was referred to the outreach team (n=11) and members of the outreach team (n=3).
Registered nurses in this study looked at trends when assessing their patients visually. However, early warning scoring was not a key component of patient assessment and was used more commonly to quantify deterioration once the patient's changing condition had been recognised. Findings demonstrated some tensions in team communication.
The results of this study suggest that clinicians need a better understanding of the value of track and trigger scoring systems in identifying trends in the patient's condition. Further, our data suggest that steps need to be taken in acute hospital wards to improve team members' understanding of each others' roles and capabilities.
英国（UK）大多数医院使用某种形式的跟踪和触发评分系统，如早期预警评分，以识别病情恶化的患者；然而，多专业团队的反应并不总是及时的，对病情恶化的识别问题仍然存在。
调查病房护士和重症监护外展工作人员对急性病房中病情恶化患者管理的看法。
采用定性设计，采用关键事件（CI）技术对数据收集进行结构。对管理过转介到外展团队的患者的护士（n=11）和外展团队成员（n=3）进行了半结构化访谈。
本研究中的注册护士在评估患者时会观察趋势。然而，早期预警评分并不是患者评估的关键组成部分，更多地用于在患者病情变化被识别后量化恶化程度。研究结果表明团队沟通存在一些紧张。
本研究结果表明，临床医生需要更好地了解跟踪和触发评分系统在识别患者病情趋势方面的价值。此外，我们的数据表明，需要在急性医院病房采取措施，以提高团队成员对彼此角色和能力的理解。
