Title Page
-
Site conducted
-
Conducted on
-
Audit conducted by
-
People consulted during this audit, if applicable
-
1. Is this audit based on a mock scenario or an actual deteriorating patient event?
-
2. Was the incident a Clinical review or a Medical Emergency Response (MET)?
-
Did the patient have any alteration to clinical escalation criteria documented by the treating doctor?
-
What clinical review criteria was met?
- Respiratory rate 5-9 or 26-30 bpm
- SaO2 90-94% and/or increase in oxygen requirement (modification for sleep patients <75% SpO2 >10mins)
- Systolic Blood Pressure 90-99 or 180-200mmHg
- Heart rate 40-49 or 120-140 beats per minute
- Decreased in Level of Consciousness from alert (A) to rousable only to voice (V) in the AVPU or new onset of confusion
- Temperature <35.5 or >38.5
- Pain score >7/10 or sudden increase in pain or chest pain
- Anuria, failure to void in 24 hours or urine output <200ml over 8 hrs
- Poor peripheral circulation
- Blood Glucose Level 1-4mmol/L
- Serious concern by any staff member or family member
-
Did a doctor conduct a patient review within 30mins of being contacted?
-
Were vital signs recorded in vital signs tab or appropriate track and trigger form?
-
What was the outcome for the patient?
- Treatment continued as planned
- Treatment delayed
- Treatment cancelled
- Transfer to Emergency Department or Hospital
- Ambulance review
- Follow up with GP
- Other - please list below
-
Other - please list
-
Please add any further comments as appropriate
-
Which medical emergency criteria was met?
- Cardiac or Respiratory arrest
- Airway obstruction or stridor
- Seizure
- Deterioration not reversed within 30mins of clinical review
- Patient deteriorates further, before or during clinical review
- Resp rate <5 or > 30 bpm
- spO2 <90% and/or increase in oxygen requirement (modification for sleep patients <75% SpO2 >10mins)
- Systolic Blood pressure <90 or >200mmHg
- Heart rate <40 or > 140 bpm
- Sudden decrease in level of consciousness (only responds to Pain (P), unresponsive (U), or a decrease f >2 points on GCS
- Blood Glucose Level <1mmol/L
- sudden (unexplainable) aggression
- Sudden change in cognitive status, new confusion
- Serious concern by any staff member or family member
-
If the incident was a medical emergency response, did the first responder initiate DRSABCD?
-
If a medical emergency, how long until the medical emergency team/ paramedics arrived?
-
Were frequent vital signs completed as per protocol?
-
Did the medical emergency result in the need for Basic Life Support measures?
-
Was an incident report completed?
-
Was a debrief conducted post the incident for staff involved? Please note significant topics to explore during a debrief Include: individual and /or group reflections. what went well during the incident? Are there any areas were we could improve?
-
Please comment
-
Were there any actions or areas of improvement identified in the incident debrief?
-
Have these addressed or logged in an action plan?
-
Deteriorating patient date: , Riskman ID # patient UR#
