Keywords

Patient deterioration, Progressive care unit, Scoping review, Step-down unit

 

Authors

  1. Krom, Zachary R. PhD, RN, CCRN, CHSE, NPD-BC

Abstract

Background: The American Heart Association set a goal in 2010 to double the percentage of hospitalized adult patients who survive cardiac arrest by 2020. Because of acuity and interventions, progressive care patients are a population of interest to address this goal. The state of the literature involving patient deterioration, which can lead to cardiac arrest, in the progressive care setting has yet to be explored.

 

Objective: A scoping review was done to investigate the literature involving patient deterioration in adult progressive care units in order to map knowledge, identify themes, and discover areas for research potential.

 

Methods: The scoping review began with an extensive literature search and a multistep review. The characteristics of the final group of studies were charted and grouped according to common themes.

 

Results: There were 13 studies in the final group. All studies were conducted in the United States and most by interprofessional teams. Three themes were evident in the review, training methods, surveillance, and monitoring systems.

 

Discussion: Patient deterioration in the progressive care unit may benefit from team-based training methods involving checklists or protocols. Nurses can use surveillance, including physical assessment and technology, to recognize early warning signs. Lastly, the use of systems that identify patterns in vital signs can be useful to reduce patient harm. Further research in this area care is warranted and could potentially improve patient outcomes and nursing practice.