Recognizing Deteriorating Patient Condition: Recommended Readings 

As part of the work to curate these tools and resources, we’ve selected the following scholarly articles that may be of interest to anyone looking to inform and improve their practices around the recognition and response to the deteriorating patient condition. 

Patients and families in early recognition of clinical deterioration 

• Severe illness getting noticed sooner: SIGNS-for-Kids—initial validity assessment of a paediatric illness recognition tool for caregivers, BMJ Open Quality (2022) 
• Severe illness getting noticed sooner – SIGNS-for-Kids: developing an illness recognition tool to connect home and hospital, BMJ Open Quality (2019) 
• Consumer participation in early detection of the deteriorating patient and call activation to rapid response systems: a literature review, Journal of Clinical Nursing (2015) 
• The effectiveness of rapid response teams activated by patients or family members of patients admitted to inpatient hospital units: a systematic review protocol, JBI Database of Systematic Reviews and Implementation Reports (2014) 
• Consumers' perspectives on their involvement in recognizing and responding to patient deterioration –-Developing a model for consumer reporting, Health Expectations (2018)      
• Developing and evaluating the success of a family activated medical emergency team: a quality improvement report, BMJ Quality and Safety (2014)    
• Barriers and facilitators to implementing a process to enable parent escalation of care for the deteriorating child in hospital, Health Expectations (2018) 
• Patient perceptions of deterioration and patient and family activated escalation systems – A qualitative study, Journal of Clinical Nursing (2017)    
• Condition Help: A Patient- and Family-Initiated Rapid Response System, Journal of Hospital Medicine (2017)  
• Is there a role for patients and their relatives in escalating clinical deterioration in hospital? A systematic review, Health Expectations (2016)   
• Advance care planning in the context of clinical deterioration: a systematic review of the literature, Journal of Palliative Care and Social Practice (2019)   
• Validity and effectiveness of paediatric early warning systems and track and trigger tools for identifying and reducing clinical deterioration in hospitalised children: a systematic review, BMJ Paediatrics Research (2018) 

Early warning and recognition in a pediatric care setting  

• An Integrative Review of Pediatric Early Warning System Scores, Continuing Nursing Education (2015) 
• Paediatric early warning scores on a children's ward: a quality improvement initiative, Nurs Child Young People, (2014) 
• No more pediatric code blues on the floor: evolution of pediatric rapid response teams and situational awareness plans, Translational Pediatrics (2018) 
• Rapid Response Teams in Pediatric Patients: Well-Intentioned, but Do They Really Help? Circulation (2018) 
• Barriers and facilitators to implementing a process to enable parent escalation of care for the deteriorating child in hospital, Health Expectations (2018) 
• Implementation of a Formal Debriefing Program After Pediatric Rapid Response Team Activations, J Grad Med Educ  (2018) 
• Association of Pediatric Medical Emergency Teams with Hospital Mortality, Circulation (2017) 
• Paediatric early warning systems for detecting and responding to clinical deterioration in children: a systematic review, BMJ Open  (2017) 
• Comparison of Pediatric Early Warning Score to Physician Opinion for Deteriorating Patients, Hospital Pediatrics (2015) 
• The Simulation-Based Assessment of Pediatric Rapid Response Teams, Journal of Pediatrics (2017) 
• Frequency of medical emergency team activation prior to pediatric cardiopulmonary resuscitation, Resuscitation Journal (2017) 
• Implementing a Quality and Safety Agenda in a Children's Hospital Within a Hospital: Challenges and Successes, Hospital Pediatrics (2016) 
• Watcher Initiative Associated With Decrease in Failure to Rescue Events in Pediatric Population, Hospital Pediatrics (2017) 
• Improving Pediatric Rapid Response Team Performance Through Crew Resource Management Training of Team Leaders, Hospital Pediatrics (2016) 

Early warning and recognition in an obstetrical care setting 

• Obstetric early warning systems to prevent bad outcome, Current Opinion in Anaesthesiology (2016) 
• Early warning systems in obstetrics: A systematic literature review, Plos One (2019)  
• Implementing Obstetric Early Warning Systems, American Journal of Perinatology Reports (2018) 
• Use of the Maternal Early Warning Trigger Tool for Early Recognition of Deterioration in Women During Birth, Innovative Programs Obstetric (2019) 
• Maternal Early Warning Scores (MEWS), World Federation of Societies of Anesthesiologists (2018) 
• Use of Maternal Early Warning Trigger tool reduces maternal morbidity, American Journal of Obstetrics & Gynecology (2016)  
• Constructing maternal morbidity – towards a standard tool to measure and monitor maternal health beyond mortality, BMC Pregnancy Childbirth (2016)  
• Obstetrical Triage Acuity Scale, Journal of Obstetrics and Gynecology Canada (2016) 
• Maternal Early Warning Systems, Obstetrics and Gynecology Clinics of North America (2015) 

Early warning and recognition in a general care setting 

• Frequency of early warning score assessment and clinical deterioration in hospitalized patients: A randomized trial, Resuscitation Journal (2016) 
• Modified Early Warning System improves patient safety and clinical outcomes in an academic community hospital, Journal of Community Hospital Internal Medicine Perspectives (2015) 
• Nurses' worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals: a systematic review, Critical Care (2015)
• Nursing and Medical Perceptions of a Hospital Rapid Response System, Journal of Nursing Care Quality (2016) 
• Barriers to activation of the rapid response system, Resuscitation Journal (2014) 
• Using Electronic Health Record Data to Develop and Validate a Prediction Model for Adverse Outcomes in the Wards, Critical Care Medicine (2014) 
• Rapid response systems: a systematic review and meta-analysis, Critical Care (2015) 
• Fostering self-determination of bedside providers to promote active participation in rapid response events, Medical Education Online (2019) 
• Is there a role for patients and their relatives in escalating clinical deterioration in hospital? A systematic review, Health Expectations (2016)