Protocol describing a systematic review and mixed methods consensus process to define the deteriorated ward patient
Introduction Most patients admitted to hospital recover with treatments that can be administered on the general ward. A small but important group deteriorate however and require augmented organ support in areas with increased nursing to patient ratios. In observational studies evaluating this cohort...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/9/e057614.full |
| _version_ | 1811338795496243200 |
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| author | Oliver C Redfern Duncan Young Peter J Watkinson James Malycha Guy Ludbrook Christian Subbe Daryl Jones Arthas Flabouris Chris Andersen Sandra Peake Lukah Dykes Adam Phillips |
| author_facet | Oliver C Redfern Duncan Young Peter J Watkinson James Malycha Guy Ludbrook Christian Subbe Daryl Jones Arthas Flabouris Chris Andersen Sandra Peake Lukah Dykes Adam Phillips |
| author_sort | Oliver C Redfern |
| collection | DOAJ |
| description | Introduction Most patients admitted to hospital recover with treatments that can be administered on the general ward. A small but important group deteriorate however and require augmented organ support in areas with increased nursing to patient ratios. In observational studies evaluating this cohort, proxy outcomes such as unplanned intensive care unit admission, cardiac arrest and death are used. These outcome measures introduce subjectivity and variability, which in turn hinders the development and accuracy of the increasing numbers of electronic medical record (EMR) linked digital tools designed to predict clinical deterioration. Here, we describe a protocol for developing a new outcome measure using mixed methods to address these limitations.Methods and analysis We will undertake firstly, a systematic literature review to identify existing generic, syndrome-specific and organ-specific definitions for clinically deteriorated, hospitalised adult patients. Secondly, an international modified Delphi study to generate a short list of candidate definitions. Thirdly, a nominal group technique (NGT) (using a trained facilitator) will take a diverse group of stakeholders through a structured process to generate a consensus definition. The NGT process will be informed by the data generated from the first two stages. The definition(s) for the deteriorated ward patient will be readily extractable from the EMR.Ethics and dissemination This study has ethics approval (reference 16399) from the Central Adelaide Local Health Network Human Research Ethics Committee. Results generated from this study will be disseminated through publication and presentation at national and international scientific meetings. |
| first_indexed | 2024-04-13T18:16:49Z |
| format | Article |
| id | doaj.art-2c967808d60a429f9327626551671b17 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-13T18:16:49Z |
| publishDate | 2022-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-2c967808d60a429f9327626551671b172022-12-22T02:35:39ZengBMJ Publishing GroupBMJ Open2044-60552022-09-0112910.1136/bmjopen-2021-057614Protocol describing a systematic review and mixed methods consensus process to define the deteriorated ward patientOliver C Redfern0Duncan Young1Peter J Watkinson2James Malycha3Guy Ludbrook4Christian Subbe5Daryl Jones6Arthas Flabouris7Chris Andersen8Sandra Peake9Lukah Dykes10Adam Phillips11Kadoorie Centre for Critical Care Research and Education, University of Oxford, Oxford, Oxfordshire, UKKadoorie Centre for Critical Care Research and Education, University of Oxford, Oxford, Oxfordshire, UKKadoorie Centre for Critical Care Research and Education, University of Oxford, Oxford, Oxfordshire, UKIntensive Care Unit, The Queen Elizabeth Hospital, Woodville South, South Australia, AustraliaDepartment of Acute Care Medicine, The University of Adelaide, Adelaide, South Australia, AustraliaSchool of Medical Sciences, Bangor University, Bangor, Gwynedd, UKIntensive Care Unit Austin Hospital, Austin Health, Heidelberg, Victoria, AustraliaDepartment of Acute Care Medicine, The University of Adelaide, Adelaide, South Australia, AustraliaCritical Care Program, The George Institute for Global Health, Newtown, New South Wales, AustraliaIntensive Care Unit, The Queen Elizabeth Hospital, Woodville South, South Australia, AustraliaFlinders University, Adelaide, South Australia, AustraliaUniversity of South Australia, Adelaide, South Australia, AustraliaIntroduction Most patients admitted to hospital recover with treatments that can be administered on the general ward. A small but important group deteriorate however and require augmented organ support in areas with increased nursing to patient ratios. In observational studies evaluating this cohort, proxy outcomes such as unplanned intensive care unit admission, cardiac arrest and death are used. These outcome measures introduce subjectivity and variability, which in turn hinders the development and accuracy of the increasing numbers of electronic medical record (EMR) linked digital tools designed to predict clinical deterioration. Here, we describe a protocol for developing a new outcome measure using mixed methods to address these limitations.Methods and analysis We will undertake firstly, a systematic literature review to identify existing generic, syndrome-specific and organ-specific definitions for clinically deteriorated, hospitalised adult patients. Secondly, an international modified Delphi study to generate a short list of candidate definitions. Thirdly, a nominal group technique (NGT) (using a trained facilitator) will take a diverse group of stakeholders through a structured process to generate a consensus definition. The NGT process will be informed by the data generated from the first two stages. The definition(s) for the deteriorated ward patient will be readily extractable from the EMR.Ethics and dissemination This study has ethics approval (reference 16399) from the Central Adelaide Local Health Network Human Research Ethics Committee. Results generated from this study will be disseminated through publication and presentation at national and international scientific meetings.https://bmjopen.bmj.com/content/12/9/e057614.full |
| spellingShingle | Oliver C Redfern Duncan Young Peter J Watkinson James Malycha Guy Ludbrook Christian Subbe Daryl Jones Arthas Flabouris Chris Andersen Sandra Peake Lukah Dykes Adam Phillips Protocol describing a systematic review and mixed methods consensus process to define the deteriorated ward patient BMJ Open |
| title | Protocol describing a systematic review and mixed methods consensus process to define the deteriorated ward patient |
| title_full | Protocol describing a systematic review and mixed methods consensus process to define the deteriorated ward patient |
| title_fullStr | Protocol describing a systematic review and mixed methods consensus process to define the deteriorated ward patient |
| title_full_unstemmed | Protocol describing a systematic review and mixed methods consensus process to define the deteriorated ward patient |
| title_short | Protocol describing a systematic review and mixed methods consensus process to define the deteriorated ward patient |
| title_sort | protocol describing a systematic review and mixed methods consensus process to define the deteriorated ward patient |
| url | https://bmjopen.bmj.com/content/12/9/e057614.full |
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