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Acutely ill adults in hospital: recognising and responding to deterioration [CG50]

Measuring the use of this guidance

Recommendation: 1.1

Adult patients in acute hospital settings, including patients in the emergency department for whom a clinical decision to admit has been made, should have: •physiological observations recorded at the time of their admission or initial assessment •a clear written monitoring plan that specifies which physiological observations should be recorded and how often. The plan should take account of the: ◦patient's diagnosis ◦presence of comorbidities ◦agreed treatment plan.

What was measured: Proportion of patients admitted to the AMU who have an early warning score measured upon arrival.
Data collection end: June 2016
59%
Area covered: UK
Source: Society for Acute Medicine Benchmarking Audit

What was measured: The proportion of patients in the study population who did not have an early warning score as part of their initial assessment.
Data collection end: March 2015
36.8%
Number that met the criteria: 159 / 432
Area covered: UK
Source: National Confidential Enquiry into Patient Outcome and Death. Acute Non-Invasive Ventilation: Inspiring Change

What was measured: Proportion of patients admitted to the acute medical unit who have an early warning score measured within 30 minutes of hospital arrival.
Data collection end: June 2017
83%
Number that met the criteria: 3773 / 4545
Area covered: UK
Source: Society for Acute Medicine Benchmarking Audit


Recommendation: 1.2

As a minimum, the following physiological observations should be recorded at the initial assessment and as part of routine monitoring: •heart rate •respiratory rate •systolic blood pressure •level of consciousness •oxygen saturation •temperature.

What was measured: Proportion of hospitals whose National Early Warning Score (NEWS) included all 6 physiological observations in recommendation 1.2 of NICE guideline CG50: •heart rate •respiratory rate •systolic blood pressure •level of consciousness •oxygen saturation •temperature.
Data collection end: July 2017
100%
Number that met the criteria: 55 / 55
Area covered: England
Source: Freathy, Simon, Smith, Gary B., Schoonhoven, Lisette et al. (2019) The response to patient deterioration in the UK National Health Service - A survey of acute hospital policies. Resuscitation



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