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Evaluation of the risk of early clinical deterioration in wards of a southeastern university hospital

Grant number: 20/06774-1
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): November 01, 2020
Effective date (End): October 31, 2021
Field of knowledge:Health Sciences - Nursing - Public Health Nursing
Principal researcher:Thaís Moreira São João
Grantee:Mariana de Souza Esteves
Home Institution: Faculdade de Enfermagem. Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil


During the hospitalization period, it is possible to observe considerable changes in patients' vital parameters, which may require emergency interventions or intensive treatment. The change in signs and symptoms that lead to physiological instability that can result in a worsening of the clinical picture with evolution to shock, respiratory failure or cardiorespiratory arrest is currently defined as clinical deterioration. Thus, the importance of identifying, early, signs of clinical deterioration can lead to a drastic decrease in mortality rates and the need for emergency interventions, in addition to unscheduled treatments in Intensive Care Units. The identification and appropriate referral of patients who show signs of clinical deterioration in an appropriate manner can be facilitated by the application of early warning systems that provide rapid responses. Nurses have a primary responsibility for detecting and preventing clinical deterioration of the patient. It is necessary to make a clinical judgment to base the professional's actions on what concerns the nursing surveillance process: intentional and continuous collection, interpretation and synthesis of data obtained from patients so that it is possible to establish the decision-making process. This project aims to estimate the risk of early clinical deterioration in all inpatient units of a public university hospital in southeastern São Paulo. It constitutes a preliminary stage of a broader study, which will train all nurses working in wards in that service. The present study will carry out the situational diagnosis stage, that is, it will allow the understanding of the problem with a view to the later design of the intervention, as recommended internationally. This is an unprecedented project that has the partnership of the Nursing department of the health institution and with foreign collaboration; with a view to implementing new lightweight technology and changing work processes that will have an impact on inpatient mortality. Its results will subsidize broader experimental studies, already in outline, with a view to training nurses for the adequate early assessment of clinical deterioration.

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