Name: Class 3_ Group 1_NC_A1
Uploaded: 2022-09-03
Duration: 4 min 3 s
Description: . . Detecting & recognising acute deterioration and escalating care.

. . Detecting & recognising acute deterioration and escalating care. 

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Detecting & recognising acute 
deterioration and escalating care

Lee Guo Hong (20724144) | Nicholas Bay Kuan Yi (20735900)

Mahaletchumy Lingeswaran (20577351)| Koh Jia Shun (20143817)

. . The importance of detecting & recognising acute deterioration. 

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The importance of detecting & recognising acute deterioration

● An important part of identifying acute deterioration is keeping track of

changes in vital signs and other observations over time

● Effective communication and proper education
● Proper management
● Staff competencies at least every year (defibrillator, code blue drill)

(Australian Commision on Safety & Quality in Healthcare, 2022)

. . Ways of escalating care. ● Early Warning Score (EWS)
● Situation ,Background, Assessment and Recommendation (SBAR)
● To have proper checks of observation charts, Input and Output charts. 

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● Early Warning Score (EWS)
● Situation ,Background, Assessment and Recommendation (SBAR)
● To have proper checks of observation charts, Input and Output charts

● Appropriate care for the rapid deterioration chronic problem
● To do proper quality checks (QC)

(Dalton et al., 2018; Vincent et al, 2019)

. . The Registered Nurse (RN) role in escalation of care. 

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The Registered Nurse (RN) role in escalation of care

Singapore Nursing Board (SNB) Core Competencies of Registered Nurses 
(Domain 2)

● Demonstrate effective communication
● Ensure consistent and continuous holistic quality of care 
● Maintain safe environment through the use of quality assurance and risk

● Failure to escalate patient’s concerns can result in treatment delays and

contribute to patient harm/or sentinel events (Cotter et al., 2019)

. . Importance of Interprofessional Relationship & the impacts. 

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Importance of Interprofessional Relationship & the impacts

● Improve patient care and outcomes
● Reduce medical errors
● Improve efficiencies and reduce healthcare costs
● Improve job satisfaction
● Improve patient experience and satisfaction

Case Study: Late Minister Mr Lee Kuan Yew thanked the healthcare 
professionals who took care of his wife when she was admitted to hospital in 
his eulogy at the funeral service of Mrs Lee Kuan Yew (Prime Minister Office, 
2022)

“Her second stroke on 12 May 2008 was more disabling. I encouraged her and 
cheered her on, helped by a magnificent team of doctors, surgeons, therapists 
and nurses”

. . How detecting and recognising acute deterioration and escalating care impacts high quality healthcare and patient safety. 

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How detecting and recognising acute deterioration and escalating care 
impacts high quality healthcare and patient safety

Non-maleficence: To do no harm to patients

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. . References. ● Australian Commision on Safety & Quality in Healthcare. (2022, August 29). Detecting and. 

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● Australian Commision on Safety & Quality in Healthcare. (2022, August 29). Detecting and

recognising acute deterioration, and escalating care. 
https://www.safetyandquality.gov.au/standards/nsqhs-standards/recognising-and-responding-
acute-deterioration-standard/detecting-and-recognising-acute-deterioration-and-escalating-
care

● Butts, J. B., & Rich, K. L. (2019). Nursing ethics: Across the Curriculum and into Practice. Jones &

● Burke, C., & Conway, Y. (2022). Factors that influence hospital nurses’ escalation of patient care

in response to their early warning score: A qualitative evidence synthesis. 1-50. Journal of 
Clinical Nursing. https://doi.org/10.1111/jocn.16233

● Cotter, J., Ziniel, S., Lockwood, J., & Reese, J. (2019). Care Escalation: Teaching residents how to

effectively communicate patient care concerns. MedEdPORTAL, 15(1). 10833. 
https://doi.org/10.15766/mep_2374-8265.10833

● Dalton, M., Harrison, J., Malin, A., & Leavey, C. (2019). Factors that influence nurses’ assessment

of patient acuity and response to acute deterioration. British Journal of Nursing. 27(4), 212-218.

. . References. ● Ede, J., Jeffs, E., Vollam, S., & Watkinson, P. (2019). A qualitative exploration of escalation of care. 

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● Ede, J., Jeffs, E., Vollam, S., & Watkinson, P. (2019). A qualitative exploration of escalation of care

in the acute ward setting. Nursing In Critical Care, 25(3), 171-178. 
https://doi.org/10.1111/nicc.12479

● Singapore Nursing Board (2022, August 30). Core competencies of Registered Nurse.

https://www.healthprofessionals.gov.sg/docs/librariesprovider4/publications/core-
competencies-generic-skills-of-rn_snb_april-2018.pdf

● Prime Minister’s Office Singapore (2022, August 14). Eulogy by Minister Mentor Lee Kuan Yew

at the Funeral Service Mrs Lee Kuan Yew Mandai. https://www.pmo.gov.sg/Newsroom/eulogy-
minister-mentor-lee-kuan-yew-funeral-service-mrs-lee-kuan-yew-mandai-crematorium

● Vincent, J-L., Einav, S., Pearse, R., Jaber, S., Kranke, P., Overdyk, F. J., Whitaker, D. K., Gordo, F.,

Dahan, A., Hoeft, A. (2018). Improving detection of patient deterioration in the general hospital 
ward environment. European Journal of Anaesthesiology. 35 (5). 325-333. doi: 
10.1097/EJA.0000000000000798

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