Evidence map›Paper›PMID 42399601›Full record

ArticleInternational journal of nursing practice2026

Acute Deterioration in Long-Term Care: A Delphi Study of Indicators, Care Pathways and Implementation Strategies.

Christina Parker, Deepa Sriram, Shirley Chambers, Linda Schnitker, Amy Spooner, Leanne Jack, Patsy Yates, Elizabeth Beattie, Margaret MacAndrew

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Article in International journal of nursing practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Christina ParkerSchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.ORCID https://orcid.org/0000-0003-3834-205X
Deepa SriramSchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
Shirley ChambersSchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
Linda SchnitkerSchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
Amy SpoonerSchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
Leanne JackSchool of Nursing, Midwifery and Social Sciences, Central Queensland University, Brisbane, Queensland, Australia.
Patsy YatesFaculty of Health, Office of the Executive Dean, Queensland University of Technology, Brisbane, Queensland, Australia.ORCID https://orcid.org/0000-0001-8946-8504
Elizabeth BeattieSchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
Margaret MacAndrewSchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.

Funding

Queensland Government Nursing and Midwifery Research Fellowship
6 · The paper itself

Abstract

aimThis study aimed to develop recommendations for acceptable physical and psychological clinical indicators of acute deterioration and strategies to support sustained adoption of an approach to detecting and responding to acute deterioration in long-term care.

backgroundPrevious studies have trialled programmes to reduce avoidable hospital transfers through early detection of acute deterioration in long-term care. However, variability in outcomes and implementation experiences highlights differences in the essential components of these approaches.

designThree-round Delphi process.

methodsThe Delphi process conducted between September 2022 and January 2023 included a 22-member Australian expert panel to elicit consensus and to generate recommendations. Delphi participants were asked to rate the potential items on a 9-point scale for level of importance (Part A), level of priority of action (Part B) and level of acceptability (Part C). The mean, standard deviation (SD) and I-CVI of each item were calculated. Clinical indicators with mean ≥ 7, I-CVI ≥ 0.78 were considered to have a good degree of agreement, appropriateness and relevance and were deemed acceptable for inclusion.

resultsParticipants completed a two-part online survey in Round 1, and three-part surveys in Rounds 2 and 3. Round 1, Part A included 44 clinical indicators. On completion of Round 3, 36 items remained. Care pathways in response to acute deterioration (n = 20) were included in Part B. After Round 3, 17 care pathways remained. There was agreement in Part C that communication aides, education and mentor programmes were necessary as viable strategies to support sustained adoption.

conclusionDetecting the early warning signs of acute deterioration will have significant outcomes for residents, staff and health care services.

Indexed as

Clinical DeteriorationLong-Term CareAustraliaDelphi TechniqueHumansSurveys and Questionnairesacute deteriorationDelphi surveyresidential aged care

Identifiers

PMID42399601
PMCPMC13331997

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.