ArticleBMC nursing2024
Indicators of clinical deterioration in adult general ward patients from nurses' perspectives: a mixed-methods systematic review.
Article in BMC nursing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Benner's Model Guiding Skill and Knowledge Acquisition of Advanced Practice Nurses.Nursing philosophy : an international journal for healthcare professionals · 2026Article
- Signs and symptoms indicating the transition to the palliative phase in patients with COPD and heart failure in primary healthcare: a mixed-methods study.BMC palliative care · 2026Article
- Turkish version of the Nurse Intuition Patient Deterioration Scale: cross-cultural adaptation and validation study.BMC nursing · 2026Article
- Immediate Effect of Whole-Body Vibration Exercise Performed in Vertical Versus Side-Alternating Displacement Modes on Physiological Parameters, Perception of Effort, Strength and Functionality in Adults with Obesity.Diagnostics (Basel, Switzerland) · 2026Article
- Setting the Next Vital Sign Observation Interval as a Learning Objective in Simulation-Based Nursing Education: A Prospective Exploratory Observational Study.Nursing reports (Pavia, Italy) · 2025Article
- Development and Validation of a NEWS2-Enhanced Multivariable Prediction Model for Clinical Deterioration and In-Hospital Mortality in Hospitalized Adults.Medicina (Kaunas, Lithuania) · 2025Article
- Ranking Nursing Diagnoses by Predictive Relevance for Intensive Care Unit Transfer Risk in Adult and Pediatric Patients: A Machine Learning Approach with Random Forest.Healthcare (Basel, Switzerland) · 2025Article
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Authors and funding
2 authors.
Funding
Abstract
backgroundEarly recognition and response to deteriorating patients in general wards are core competencies for nurses. Clinical deterioration is a worsening condition that increases the risk of morbidity and mortality. Although objective measures are commonly used, recent research suggests that subjective data and nurses' intuitions can serve as valuable indicators for early detection of deterioration in patients. This study aims to comprehensively identify and classify the indicators used to detect clinical deterioration in patients hospitalized in general wards from nurses' perspectives.
methodsThis is a mixed-methods systematic review followed a Joanna Briggs Institute Methodology convergent integrated approach. Four electronic databases (PubMed, CINAHL, Embase, and Scopus) were searched. Studies were screened based on the population of interest (nurses), the phenomenon of interest (patient deterioration), the context (adult care in acute hospital settings), the study type (original studies), and publication in English peer-reviewed journals from January 2014 to December 2023. Two authors independently conducted all screening steps and assessed the methodological quality of the included studies. Any disagreements were resolved through discussion. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis.
resultsTwenty-one studies met the eligibility criteria. Key indicators included vital signs, intake and output, laboratory data, and observational data. Nurses also relied on subjective data from patients' complaints and their own intuition to predict patient deterioration. The frequency and pattern of specific nursing interventions also play an important role.
conclusionsThis review identified vital indicators from nurses' perspectives, underscoring the value of subjective observations, intuition, and specific nursing interventions in predicting patient deterioration. Integrating subjective factors with objective data can improve early recognition of and response to clinical deterioration, thereby enhancing patient safety and outcomes. This review provides a foundation for future research aimed at quantifying subjective elements, such as patient complaints and nurses' intuitions, to be included in nursing records as key indicators for predicting patient deterioration. TRIALS REGISTRATION: This study was registered with PROSPERO under the registration number CRD42024552344.
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