Clinical Deterioration

There is a worldwide implementation of a patient-safety programme, known as rapid response system (RRS), in acute care hospitals with the optimal goal to provide safe and quality care to a deteriorating patient.

Here, we are specifically focusing on enhancing nurses’ roles in recognising and responding to clinical deterioration. We have developed simulation-based programmes and evaluated the impact on healthcare providers. We have also developed and psychometric tested several instruments to measure attitudes and competencies related to clinical deterioration.

Core Members: Dr Weiling CHUA, Prof Sok Ying LIAW

Publications

  • Chua WL, Rusli KDB, Aitken LM.. Early warning scores for sepsis identification and prediction of in-hospital mortality in adults with sepsis: A systematic review and meta-analysis. J Clin Nurs. 2024 Jun;33(6):2005-2018. doi: 10.1111/jocn.17061. Epub 2024 Feb 20.. 10.1111/jocn.17061

  • Hong JQY, Chua WL, Smith D, Huang CM, Goh QLP, Liaw SY.. Collaborative practice among general ward staff on escalating care in clinical deterioration: A systematic review. J Clin Nurs. 2023 Sep;32(17-18):6165-6178. doi: 10.1111/jocn.16743. Epub 2023 May 8.. 10.1111/jocn.16743

  • Chua WL, Wee LC, Lim JYG, Yeo MLK, Jones D, Tan CK, Khan FA, Liaw SY.. Automated rapid response system activation-Impact on nurses' attitudes and perceptions towards recognising and responding to clinical deterioration: Mixed-methods study. J Clin Nurs. 2023 Sep;32(17-18):6322-6338. doi: 10.1111/jocn.16734. Epub 2023 Apr 23.. 10.1111/jocn.16734

  • Chua WL, Teh CS, Basri MABA, Ong ST, Phang NQQ, Goh EL.. Nurses' knowledge and confidence in recognizing and managing patients with sepsis: A multi-site cross-sectional study. J Adv Nurs. 2023 Feb;79(2):616-629. doi: 10.1111/jan.15435. Epub 2022 Sep 7.. 10.1111/jan.15435

  • Chua WL, Smith D, Wee LC, Ting KC, Yeo MLK, Mordiffi SZ, Liaw SY.. Development and psychometric evaluation of the Attitudes Towards Recognising Early and Noticeable Deterioration (ATREND) scale. J Clin Nurs. 2023 Jun;32(11-12):2684-2699. doi: 10.1111/jocn.16350. Epub 2022 May 8.. 10.1111/jocn.16350

  • Chua, W. L., Rahim, N., McKenna, L., Ho, J., & Liaw, S. Y. (2022). Intraprofessional collaboration between enrolled and registered nurses in the care of clinically deteriorating ward patients: A qualitative study. Australian Critical Care: official journal of the Confederation of Australian Critical Care Nurses, 35(1), 81–88. https://doi.org/10.1016/j.aucc.2021.01.009

  • Chua, W. L., Smith, D., Wee, L. C., Ting, K. C., Yeo, M., Mordiffi, S. Z., & Liaw, S. Y. (2022). Development and psychometric evaluation of the Attitudes Towards Recognising Early and Noticeable Deterioration (ATREND) scale. Journal of clinical nursing, 10.1111/jocn.16350. Advance online publication. https://doi.org/10.1111/jocn.16350

  • Liaw, S.Y c., Sutini., Chua, W.L., Levett-Jones, T., Ashokka B., Pan T.L., Lau, S.T. & Ignacio, J. (2022). Desktop virtual reality versus face-to-face simulation for team-training on stress levels and performance in clinical deterioration: A randomized controlled trial. Journal of General Internal Medicine. Advance online publication. doi: 10.1007/s11606-022-07557-7

  • Chua, W. L., Tee, A., Hassan, N. B., Jones, D., Tam, W., & Liaw, S. Y. (2021). The development and psychometric evaluation of the Clinicians' Attitudes towards Responding and Escalating care of Deteriorating patients scale. Australian critical care : official journal of the Confederation of Australian Critical Care Nurses, 34(4), 340–349. https://doi.org/10.1016/j.aucc.2020.08.008

  • Chua, W. Lc., Legido-Quigley, H., Ng, P. Y., McKenna, L., Hassan, N. B., & Liaw, S. Y. (2019). Seeing the whole picture in enrolled and registered nurses' experiences in recognizing clinical deterioration in general ward patients: A qualitative study. International Journal of Nursing Studies, 95, 56–64. https://doi.org/10.1016/j.ijnurstu.2019.04.012

Relevant Categories
Clinical Deterioration
Collaborative Practice
Workforce and Competency
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Related Publications

Grant - Liaw, S.Y. (PI) 2020-2022. Academic Research Fund Tier 1. Recognising and escalating care for deteriorating patients: Psychometric scale testing and survey of general ward nurses, $122,895. Ministry of Education

Chua, W. L., Rahim, N., McKenna, L., Ho, J., & Liaw, S. Y. (2022). Intraprofessional collaboration between enrolled and registered nurses in the care of clinically deteriorating ward patients: A qualitative study. Australian Critical Care: official journal of the Confederation of Australian Critical Care Nurses, 35(1), 81–88. https://doi.org/10.1016/j.aucc.2021.01.009

Chua, W. L., Smith, D., Wee, L. C., Ting, K. C., Yeo, M., Mordiffi, S. Z., & Liaw, S. Y. (2022). Development and psychometric evaluation of the Attitudes Towards Recognising Early and Noticeable Deterioration (ATREND) scale. Journal of clinical nursing, 10.1111/jocn.16350. Advance online publication. https://doi.org/10.1111/jocn.16350