The determinants of nursing staff escalating clinical deterioration out-of-hours: A mixed methods systematic review - PubMed
4 hours ago
- #out-of-hours-care
- #clinical-deterioration
- #nursing
- The study focuses on the determinants of nursing staff escalating clinical deterioration out-of-hours (night and weekends).
- Despite rapid response systems and early warning tools, adverse outcomes persist out-of-hours when patient morbidity and mortality are higher.
- The review synthesizes literature to understand the determinants of nursing staff escalating care for clinically deteriorating patients out-of-hours.
- Five key determinants identified: 'hospital at night' challenges, workforce composition and team dynamics, organizational oversight, clinical nursing workflow, and individual behavior determinants.
- The review highlights the need for targeted interventions like increasing psychological safety, integrating automated vital signs monitoring, and redesigning communication pathways.
- Staffing models and skill-mix require reassessment to address out-of-hours challenges.
- Future research should focus on feasible, context-sensitive interventions informed by behavioral and human factors science.