Prioritising Responses Of Nurses To deteriorating patient Observations (PRONTO)

Quality and Patient Safety

Vital signs are the most common assessment technique employed in healthcare. If physiological signs of deterioration are missed, misinterpreted or mismanaged, then critical illness, cardiac arrest, unplanned intensive care admissions and death may result.

Challenge

How do we improve nurses’ recognition and response to abnormal vital signs in patients?

Solution

Develop and measure the effectiveness of the PRONTO (Prioritising Responses Of Nurses To deteriorating patient Observations) intervention to improve nurses’ recognition and response to abnormal vital signs.

Impact

If successful, the research will improve patient care and safety, and health service delivery, as well as inform knowledge translation strategies in health services.

Partners

University of Adelaide

Australian National University

Bangor University (UK)

University of Ottawa, Canada

Alfred Health

Monash Health

Eastern Health – Victoria

The Australian Commission on Safety and Quality in Health Care

SA Health

Vital signs are the most common assessment technique employed in healthcare. If physiological signs of deterioration are missed, misinterpreted or mismanaged, then critical illness, cardiac arrest, unplanned intensive care admissions and death may result. Early detection requires frequent and accurate measurement of vital signs by nurses, intervention and escalation to appropriate clinicians. Failure to do so may result in serious patient complications and have significant cost implications for health services.

Led by Alfred Deakin Professor Tracey Bucknall, PRONTO is measuring the effectiveness of an intervention to improve nurses’ recognition and response to abnormal vital signs. If successful, the research will improve patient care and safety, and health service delivery, as well as inform knowledge translation strategies in health services.

Researchers are conducting a randomised trial in four Victorian hospitals, with the goal of improving the uptake of clinical practice guidelines for identifying and managing deteriorating patients in hospitals. The study uses a facilitated implementation approach, tailored to a local ward context to improve patient care, as evidence suggests practice changes can be made successfully when this approach is used.

Nurses are offered support throughout the process and any barriers to improving patient safety and clinical practice are addressed. Findings will inform the intervention utility and knowledge translation measurement approaches. If successful, the study methodology and intervention has potential for translation to other healthcare standards.

The study is funded through the NHMRC Partnership Project Scheme.

“Despite a growing body of evidence that shows the benefit of early recognition and management of patients, there is a gap between what the research is telling us that we need to do and what happens in the clinical setting. With this study we are looking at ways to close this gap.”

Alfred Deakin Professor Tracey Bucknall