Is there a role for patients and their relatives in monitoring, detecting and escalating clinical patient deterioration in hospital? A narrative review
Background: A number of measures exist to improve the early recognition of and appropriate response to the deteriorating patient such as the use of early warning scoring systems and the establishment of rapid response teams (RRT). RRT consist of medical and nursing staff with critical care skills who provide timely treatment to support deteriorating patients on the ward. Despite these measures, some patients who are deteriorating continue to go unrecognised by healthcare staff and appropriate, timely action is not always taken. In this situation, patients and relatives may intuitively sense that the patient is deteriorating. Subsequently, some hospitals have allowed the opportunity for patients and relatives to bypass healthcare staff and activate the RRT themselves when they suspect deterioration.

This narrative review examines what patient and relative activated RRS are in use to improve the early detection of and response to deterioration, their effectiveness at preventing clinical deterioration in hospitalised patients and healthcare professionals and patients’ perceptions of their acceptability and usability.

Primary outcomes
  • Measurable outcomes affecting patients including rates mortality, cardiac arrest and ICU admissions.
  • Measurable outcomes affecting healthcare staff including rates of false positive patient and relative activated RRT.
Along with these outcomes, data will be synthesised to answer the research questions.