BACKGROUND The Nursing team is usually the first to identify clinical changes in patients. However, although we know that early recognition of clinical deterioration is the key to early intervention and that early intervention leads to better results, we do not always obtain the most appropriate intervention. OBJECTIVE To describe a study protocol of a professional training program developed for nurses to implement early clinical deterioration risk assessment. METHODS This is an intervention protocol structured according to the recommendations of the SPIRIT Declaration 2013. RESULTS This paper presents the layout of a nurse-driven intervention, which will allow other people to reply to it. A systematically mapped intervention will subsidize better allocation of resources and optimization of results, improving the performance of nurses in detecting clinical deterioration. CONCLUSIONS It is hoped that this study will help health professionals improve their approach to patients who present clinical deterioration early. CLINICALTRIAL This Study Protocol was forwarded to the Brazilian Registry of Clinical Trials (ReBEC) with the number RBR-5hq9y3k.
Background During the hospitalization period, it is possible to observe considerable changes in the vital parameters of patients, which may require emergency interventions or intensive treatment. The alteration of signs and symptoms that lead to physiological instability that can worsen the clinical picture with progression to shock, respiratory failure, or cardiorespiratory arrest is currently defined as clinical deterioration. Identifying signs of clinical deterioration at an early stage can lead to substantial decreases in mortality rates, the need for emergency interventions, and unscheduled treatments in intensive care units. Identifying and appropriately referring patients who show signs of clinical deterioration can be facilitated by applying early warning systems that provide rapid responses. The nursing team is usually the first to identify clinical changes in patients. Although the literature demonstrates that early recognition of clinical deterioration is the key to early intervention and leads to better outcomes, we only sometimes pursue the most appropriate intervention. Objective This study aims to implement and evaluate an evidence-based professional training program designed for nurses and coordinated by a nurse using the “just-in-time” methodology and the National Early Warning Score 2 (NEWS2) to assess the risk of early clinical deterioration and appropriate referral in inpatient units of a public university hospital in southeastern Brazil. Methods This intervention protocol is structured according to the recommendations of the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) Declaration 2013. The type of training to be offered, “Just-in-Time Training,” consists of a teaching modality that facilitates the delivery of a time-based and work-based education, with greater emphasis on providing on-the-job learning as needed. A qualitative stage will also be conducted through focus groups and interviews with nurses to verify the factors that influence the professional practice related to the early evaluation of the clinic. A script of previously tested questions will guide and standardize the different groups. The data will define the intervention’s elements: the strategy, the type of training, the location, the teaching methodology, and the teaching material. Results The study has received authorization from the ethics committee, and participants will be recruited in July 2023. Data collection should be completed in October of the same year. The results obtained at the end of this research will be shared with the participating nursing team through the presentation of reports. In addition, the research results will be submitted to scientific journals and presented at international scientific conferences. Conclusions This study will support nurses and possibly other clinicians to improve their approach to early recognition of clinical deterioration in patients. Trial Registration Brazilian Registry of Clinical Trials RBR-5hq9y3k; https://ensaiosclinicos.gov.br/rg/RBR-5hq9y3k International Registered Report Identifier (IRRID) PRR1-10.2196/47293
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