Recognising and Responding to the Deteriorating Patient


Serious adverse events, such as unexpected death, intensive care admission and cardiac arrest, are often preceded by observable physiological, clinical abnormalities and deterioration. Other serious events, such as suicide and aggression, are also often preceded by observed or reported changes in a person’s behaviour or mood that can indicate deterioration in their mental state.
Early identification of deterioration may improve outcomes and decrease interventions required to stabilise patients whose condition deteriorates in a health service organisation.

The warning signs of clinical deterioration are not always identified or responded to appropriately. The organisational and workforce factors that contribute to a failure to recognise and respond to a deteriorating patient are complex and overlapping (Australian Commission on Quality and Safety in Health Care, 2017)


Question 1 (750 words)

The condition of your patient Joanna Cleese described in the ISBAR handover, appears to bechanging. (Please refer to the attached documentation)

Using the information that you have identified from the NOC and the ISBAR case studyhandover:

  1. Discuss the possible causes of Joanna’s changing condition, supporting yourresponse with contemporary literature and the associated significant cues, signsand symptoms listed in the case study.
  2. Explain what possible further deterioration could occur for this patient, with adetailed evidenced -based response.
    (Please support your justification and rationales with quality peer-reviewed literature).

Question 2 (750 words)

There are many tools that can be utilised when assessing a patient. When assessing adeteriorating patient accurate assessment is essential. Compare and contrast the following methods of patient assessment and their appropriate applications for the deteriorating patient.

  1. Primary (ABCDE)
  2. Head to toe assessment

Question 3 (500 words)

A change in a patient’s heart rate, blood pressure, temperature and respiratory rate can allbe an indication of clinical deterioration. It has been suggested that a changing respiratoryrate is the earliest indication of clinical deterioration and yet it is often not measuredcorrectly, or not measured at all. Using evidence-based literature to support yourarguments:

  1. Discuss why a changing respiratory rate is an important indicator of clinicaldeterioration.
  2. Explain how the respiratory rate can be measured reliably and accurately.