Avaliação da relação entre a qualidade da anotação dos parâmetros fisiológicos, o Escore para Alerta Precoce e a adoção do Plano de Ação em enfermaria de um Hospital Universitário
DOI:
https://doi.org/10.34019/1982-8047.2023.v49.40795Keywords:
Physiologic Monitoring, Early Warning Score, Clinical Deterioration, Hospital Rapid Response TeamAbstract
Introduction: Preventable adverse events may result from unnoticed clinical deterioration in inpatients, which are often preceded by changes in warning signs, thus providing an opportunity for early intervention. The adoption of the Rapid Response Team (ERR) can improve the outcome; however, it is highly dependent on monitoring of the physiological parameters and on notification of the ERR. Objective: to evaluate the quality of information in medical records and the care response to patients in wards with worsening of the clinical status, which resulting in death or transfer to the ICU in a University Hospital and provide data for future comparison of results after ERR deployment. Material and Methods: descriptive retrospective cohort study of 128 medical records of patients with clinical worsening who died in death or admission to the ICU (“event”). The physiological parameters, the score on the Early Warning Score and the Action Plan recorded in 11 moments that preceded the “event” were collected, resulting in 11 scores. The relationship between the Early Warning Score and Action Plan execution was classified as “adequate”, “inadequate” or “absent”. Results: The further away from the moment of occurrence of the “event”, greater the number of missing data, causing non-calculable Early Warning Scores. The number of adequate cases was smaller the further away the “event” was from the moment of measurement of the physiological parameters. Conclusion: Response times were inadequate to the Action Plan. Failure to rescue patients in the clinic is a complex and multifactorial issue, but it is believed that in the present report this was due, at least in part, to inadequate recording of physiological parameters. Efforts should be made to reinforce the importance of recording physiological parameters, recognizing, intervening, and communicating injuries, which are essential for the correct functioning of the afferent and efferent loops of the ERR.
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Copyright (c) 2024 Maria Cristina Vasconcellos Furtado, Sergio Paulo dos Santos Pinto, Angela Maria Gollner, Alfredo Chaoubah, Felipe Arthur de Almeida Jorge
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