Improved monitoring of low acuity ward patients is needed to help reduce failure-to-rescue rates. Contrary to previously accepted perceptions that more complex monitoring is not possible on general wards, there is an increasing body of experience demonstrating that the tools required for such monitoring are not only available but may also be easily used. Clearly the aim of improved monitoring in these areas is not to convert them into ICUs, but to enable early identification of patient deterioration such that an appropriate response can be mounted without increasing nurse workload. Increasingly, monitoring will be automated with devices combining variables to trigger a single alert when combined cut-offs are met. More data are needed to define what these cut-offs should be, which patients will benefit most from more intensive monitoring, and which variables should be monitored in which patients. Importantly, more monitoring, use of an early warning score or availability of an RRT cannot alone reduce failure-to-rescue rates and improve patient outcomes; combined, effective application of all three components is needed and must be adapted to local patient casemix, staff skills and training, and institutional capability.
Assistance with the study: none.
Financial support and sponsorship: this study was supported by an unrestricted educational grant from Medtronic. The funder had no role or input in writing the report.
Conflicts of interest: SE has received funding for travel, given lectures, owns patents with and/or performed consultancy work for Zoll, Medtronic and Diasorin and has participated in multicentre trials run by Artisanpharma, Eisai and Astra Zeneca. RP holds research grants and has given lectures and/or performed consultancy work for Nestle Health Sciences, BBraun, Medtronic, Glaxo Smithkline and Edwards Lifesciences. SJ has received consulting fees from Drager, Hamilton, Baxter, Xenios and Fisher & Paykel. PK has received lecture fees from FreseniusKabi, MSD, Ratiopharm, Medtronic. FJO is a consultant for Medtronic: Minimally Invasive Therapies Group. DKW has given lectures and/or performed consultancy work for Aguettant and Medtronic. FG has performed consultancy work for Medtronic and received grants for training from Medtronic, Philips, Merck Sharp and Dome and Dräger Medical. AD holds research grants and has given lectures and/or performed consultancy work for MSD, Medtronic, Grünenthal, Medasense, Eurocept. AH has performed consultancy work for BBraun, Edwards, UPmed and Medtronic.
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