School of Nursing & Midwifery, Central Queensland University, Bundaberg, Queensland, Australia.
School of Nursing & Midwifery, Central Queensland University, Rockhampton, Queensland, Australia.
Aust J Rural Health. 2023 Jun;31(3):385-394. doi: 10.1111/ajr.12971. Epub 2023 Feb 19.
Physiological signs of clinical deterioration are known to occur in the hours preceding a serious adverse event. As a result, track and trigger systems known as early warning systems (EWS) were introduced and routinely implemented as patient observation tools to trigger an alert in the presence of abnormal vital signs.
The objective aimed to explore the literature pertaining to EWS and their utilisation in rural, remote and regional health care facilities.
The Arksey and O'Malley's methodological framework was used to guide the scoping review. Only studies reporting on rural, remote and regional health care settings were included. All four authors participated in the screening, data extraction and analysis process.
Our search strategy yielded 3869 peer-reviewed articles published between 2012 and 2022, with six studies ultimately included. Collectively, the studies included in this scoping review examined the complex interaction between patient vital signs observation charts and recognition of patient deterioration.
Whilst rural, remote and regional clinicians use EWS to recognise and respond to clinical deterioration, noncompliance dilutes the tool's effectiveness. This overarching finding is informed by three contributing factors: documentation, communication and challenges specific to the rural context.
The success of EWS relies on accurate documentation and effective communication within the interdisciplinary team to support appropriate responses to clinical patient decline. More research is required to understand the nuances and complexities of rural and remote nursing and to address challenges associated with the use of EWS in rural health care settings.
众所周知，在发生严重不良事件前的数小时内，临床恶化的生理迹象就会出现。因此，引入了称为早期预警系统（EWS）的跟踪和触发系统，并将其常规用作患者观察工具，以便在出现异常生命体征时发出警报。
本研究旨在探讨 EWS 相关文献及其在农村、偏远和地区医疗保健设施中的应用。
采用阿特金森和奥马利的方法论框架来指导这篇范围综述。仅纳入报告农村、偏远和地区医疗保健环境的研究。所有四位作者都参与了筛选、数据提取和分析过程。
我们的搜索策略产生了 2012 年至 2022 年间发表的 3869 篇同行评审文章，最终有 6 项研究被纳入。总的来说，这篇范围综述中纳入的研究考察了患者生命体征观察图表与识别患者恶化之间的复杂相互作用。
虽然农村、偏远和地区的临床医生使用 EWS 来识别和应对临床恶化，但不遵守规定会降低该工具的有效性。这一总体发现受到三个因素的影响：文档记录、沟通以及农村环境特有的挑战。
EWS 的成功依赖于跨学科团队内准确的文档记录和有效的沟通，以支持对临床患者病情下降做出适当的反应。需要进一步研究以了解农村和偏远地区护理的细微差别和复杂性，并解决农村医疗保健环境中使用 EWS 相关的挑战。
