See the published version of this article at BMC Health Services Research.
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Research article
Tracy Flenady
Central Queensland University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5286-4789
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Health Services Research.
Background: Early warning systems (EWS) are most effective when clinicians monitor patients’ vital signs and comply with the recommended escalation of care protocols once deterioration is recognised.
Objectives: To explore sociocultural factors influencing acute care clinicians’ compliance with an early warning system commonly used in Queensland public hospitals in Australia.
Methods: This interpretative qualitative study utilised inductive thematic analysis to analyse data collected from semi-structured interviews conducted with 30 acute care clinicians from Queensland, Australia.
Results: This study identified that individuals and teams approached compliance with EWS in the context of 1) the use of EWS for patient monitoring; and 2) the use of EWS for the escalation of patient care. Individual and team compliance with monitoring and escalation processes is facilitated by intra and inter-professional factors such as acceptance and support, clear instruction, inter-disciplinary collaboration and good communication. Noncompliance with EWS can be attributed to intra and inter-professional hierarchy and poor communication.
Conclusions: The overarching organisational context including the hospital’s embedded quality improvement and administrative protocols (training, resources and staffing) impact hospital-wide culture and influence clinicians’ and teams’ compliance or non-compliance with early warning system’s monitoring and escalation processes. Successful adoption of EWS relies on effective and meaningful interactions among multidisciplinary staff.
Keywords
Early Warning Systems, Nursing, Compliance, Patient Safety, Conceptual framework, Qualitative research, Sociocultural
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CURRENT STATUS: Published
Version 3
Posted 06 Aug, 2020
Published
On 11 Aug, 2020
No community comments so far
Editorial decision: Accept
On 23 Jul, 2020
Editor assigned
On 16 Jul, 2020
Submission checks complete
On 15 Jul, 2020
Editor invited
On 15 Jul, 2020
No comments provided
Editor assigned
On 10 Jul, 2020
Submission checks complete
On 09 Jul, 2020
Editor invited
On 09 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 06 Jul, 2020
Review #2 received
Received 30 Jun, 2020
Reviewer #2 agreed
On 29 Jun, 2020
Review #1 received
Received 26 Apr, 2020
Reviewer #1 agreed
On 01 Apr, 2020
Editor assigned
On 13 Feb, 2020
Reviewers invited
Invitations sent on 13 Feb, 2020
Submission checks complete
On 12 Feb, 2020
Editor invited
On 12 Feb, 2020
First submitted
On 21 Jan, 2020
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PDF Downloads: ...
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This preprint is under consideration at BMC Health Services Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Tracy Flenady
Central Queensland University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5286-4789
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 06 Aug, 2020
Published
On 11 Aug, 2020
No community comments so far
Editorial decision: Accept
On 23 Jul, 2020
Editor assigned
On 16 Jul, 2020
Submission checks complete
On 15 Jul, 2020
Editor invited
On 15 Jul, 2020
No comments provided
Editor assigned
On 10 Jul, 2020
Submission checks complete
On 09 Jul, 2020
Editor invited
On 09 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 06 Jul, 2020
Review #2 received
Received 30 Jun, 2020
Reviewer #2 agreed
On 29 Jun, 2020
Review #1 received
Received 26 Apr, 2020
Reviewer #1 agreed
On 01 Apr, 2020
Editor assigned
On 13 Feb, 2020
Reviewers invited
Invitations sent on 13 Feb, 2020
Submission checks complete
On 12 Feb, 2020
Editor invited
On 12 Feb, 2020
First submitted
On 21 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Health Services Research.
Background: Early warning systems (EWS) are most effective when clinicians monitor patients’ vital signs and comply with the recommended escalation of care protocols once deterioration is recognised.
Objectives: To explore sociocultural factors influencing acute care clinicians’ compliance with an early warning system commonly used in Queensland public hospitals in Australia.
Methods: This interpretative qualitative study utilised inductive thematic analysis to analyse data collected from semi-structured interviews conducted with 30 acute care clinicians from Queensland, Australia.
Results: This study identified that individuals and teams approached compliance with EWS in the context of 1) the use of EWS for patient monitoring; and 2) the use of EWS for the escalation of patient care. Individual and team compliance with monitoring and escalation processes is facilitated by intra and inter-professional factors such as acceptance and support, clear instruction, inter-disciplinary collaboration and good communication. Noncompliance with EWS can be attributed to intra and inter-professional hierarchy and poor communication.
Conclusions: The overarching organisational context including the hospital’s embedded quality improvement and administrative protocols (training, resources and staffing) impact hospital-wide culture and influence clinicians’ and teams’ compliance or non-compliance with early warning system’s monitoring and escalation processes. Successful adoption of EWS relies on effective and meaningful interactions among multidisciplinary staff.
Figure 1
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