Nurses' concern can predict patient deterioration, study finds

Seventy-seven percent of nurses correctly predicted patient deterioration, with accuracy rates significantly higher in nurses with more than a year of experience, according to a Mayo Clinic study published in JAMIA Open

Researchers from the Rochester, Minn.-based hospital evaluated nurses' ability to detect future physiological deterioration based on a five-point score called the "worry factor." They asked nurses to report real-time changes in their sense of worry for patients. Researchers collected this data from two medical and two surgical adult hospital units, covering 31,159 shifts for 3,185 different patients. Cases were evaluated by three independent reviewers. 

Of the 492 potential deterioration events nurses identified, reviewers confirmed 380 of them, or 77 percent. Nurses with more than a year of experience had a 79 percent accuracy rate, compared to 68 percent for those with less experience. A patient with a worry factor score of three or more was 40 times more likely to require intensive care unit transfer within 24 hours, further supporting the theory that nurses' sense of worry can accurately identify deteriorating patients.

Research suggests that at least some of nurses' accuracy is due to a pattern recognition process, not just objective vital sign information. The researchers recommend that nurse concern regarding patient deterioration be incorporated in EMRs. 

For the full study, click here.

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