Monitoring Instability in Hospital Patients Found to Reduce Mortality

Researchers at an Australian hospital found that more closely monitoring patients for signs of instability led to reduced mortality, according to findings published in the journal Resuscitation.

Imogen Mitchell, MD, and colleagues at Canberra Hospital conducted a prospective, controlled intervention in adult patients admitted to four medical and surgical wards during a four-month period to determine whether the introduction of a multi-faceted intervention to detect clinical deterioration in patients would decrease the rate of predefined adverse outcomes.

In the study, 1,157 patients were admitted to medical wards, and 985 to surgical wards. A sub-group of patients underwent vital sign and medical review analysis pre-intervention (427) and post-intervention (320). Outcome measures included number of unplanned admissions to the intensive care unit (ICU), Medical Emergency Team (MET) reviews and unexpected hospital deaths, vital sign documentation frequency and incidence of a medical review following clinical deterioration.

Of the patients admitted to medical wards, 21 were seen in unplanned admissions to ICU and 11 experienced unexpected hospital deaths during the intervention period; while five patients admitted to surgical wards were admitted to the ICU and there were two unexpected hospital deaths. In both groups, medical reviews for patients with significant clinical instability and number of patients receiving a MET review increased during the intervention period, and mean daily frequency of documentation of all vital signs increased.

The researchers concluded that “the introduction of a multi-faceted intervention to detect clinical deterioration may benefit patients through increased monitoring of vital signs and the triggering of a medical review following an episode of clinical instability.”