One of the most exciting initiatives our hospital has developed is the Early Recognition of the Deteriorating Patient (ERDP) program.
The program is delivered as COMPASS, a set of tools that assist the bedside nurse in the early recognition of deteriorating patients, and empower them to initiate an appropriate medical review and timely medical management well before they crash and burn.
This project arose from evidence in the existing literature that there is a failure to recognise and appropriately manage deteriorating patients on the general ward. This is evidenced by delays in admission to the intensive care unit (ICU), unexpected referrals to intensive care and unexpected deaths often being preceded by significant physiological disturbances .
The ability to detect early deterioration in patients allows early appropriate intervention. Early intervention can reduce unplanned admissions to the intensive care unit and unexpected deaths .
- a new observation chart tool.
- a track and trigger system.
- a locally developed COMPASS education package.
After the initial pilot of this program was run on 4 wards at 2 hospitals during 2006, there was a decrease in unplanned ICU admissions (21 to 5, p=0.005) and cardiac arrests (4 to 0, p=0.03). Medical emergency team reviews increased from 27 to 51 (p<0.001) and the number of hospital deaths decreased from 35 to 16 (2.9% to 1.6% of all first admissions, p=0.05).
I highly recommend this program (particularly the education package) to everyone from nursing students to consultants to nursing unit managers, as a tool toÂ increase both the quality of care delivery and reduce the morbidity and mortality of patients.
You (or your hospital)Â might like to check it out.
- National Australian Institute of Project Management Awards 2008: Community Service and/or Development Project of the Year [↩]