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"Transforming nursing assessment in acute hospitals: A cluster randomis" by Clint Douglas, Sergey Alexeev et al.

Background: Patient safety is threatened when early signs of clinical deterioration are missed or not acted upon. This research began as a clinical–academic partnership established around a shared concern of nursing physical assessment practices on general wards and delayed recognition of clinical deterioration. The outcome was the development of a complex intervention facilitated at the ward level for proactive nursing surveillance. Methods: The evidence-based nursing core assessment (ENCORE) trial was a pragmatic cluster-randomised controlled trial. We hypothesised that ward intervention would reduce the incidence of patient rescue events (medical emergency team activations) and serious adverse events. We randomised 29 general wards in a 1:2 allocation, across 5 Australian hospitals to intervention (n = 10) and usual care wards (n = 19). Skilled facilitation over 12 months enabled practitioner-led, ward-level practice change for proactive nursing surveillance. The primary outcome w ....

Clinical Deterioration , Nursing Assessment , Patient Safety , Pragmatic Clinical Trial ,