Review decision: March 2016

We checked this guideline and decided that it should not be updated at this time. For details, see the update decision, decision matrix, response to stakeholders’ comments and the process for deciding if an update is needed.

Next review date: 2017

Sometimes, the health of a patient in hospital may get worse suddenly (this is called becoming acutely ill). There are certain times when this is more likely, for example following an emergency admission to hospital, after surgery and after leaving critical care. However, it can happen at any stage of an illness. It increases the patient's risk of needing to stay longer in hospital, not recovering fully or dying.

Monitoring patients (checking them and their health) regularly while they are in hospital and taking action if they show signs of becoming worse can help avoid serious problems.

This guideline describes how patients in acute hospitals should be monitored to help identify those whose health becomes worse and how they should be cared for if this happens.

The advice in the guideline covers:

  • all adult patients in hospital, including patients in the emergency department being admitted to hospital and those being moved between departments.

It does not specifically look at the care of:

  • children
  • patients in critical care areas, for example in an intensive care or high dependency unit
  • people who are having treatment for symptoms and pain in the final stages of a terminal illness.

This guideline was previously called acutely ill patients in hospital: recognition of and response to acute illness in adults in hospital.

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.

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