The Risk of Acute Deterioration (RAD) conceived as the patient status at risk for progression, with severe damage or life-threatening conditions, includes possible progression, emergence or recurrence of serious adverse-events Literature related with physiological parameters such blood pressure, cardiac or respiratory alterations and the capacity for a rapid identification of these RAD as predictors of preventable complications and adverse events The hematological patients with complex processes derived from his tumor, comorbidities and complexity hospitalized, may require admission to Iintensive care or unexpected death. Determine the patient profile that needs prevention and nursing activities and control for the risk of acute deterioration RAD at the centres of the Catalan Institute of Oncology-ICO, for 2018.
Retrospective multicenter cross-sectional study. Scope: 8 oncological units ICO-L’Hospitalet, ICO-Badalona and ICO-Girona. Data obtained from anonymized registries system of the electronic clinical history of patients.January to December of 2018.
From 6.003 episodes of hospitalized patients, 2.661 contained an indicator of RAD as main nurse diagnostic on register, representing 44.3% of the cases. Observation and intensive surveillance or semi-intensive is fundamental. Nurses’ early identification of RAD and 39.06% needed intensive or semi-surveillance.Total deaths 10.68%. The registration of interventions: systematic control of mental state (77.09%); control of respiratory frequency in 29.14%; simultaneous recording of 5 vital signs (26.60%); 4 vital signs (82.16%); intake/out control (18.67%); record of diuresis (80.86%).
Nurses most performed and registered activities were control of heart rate, blood pressure, Sat. O2, temperature, diuresis and mind alert. Low registration for FR, despite being identified as a key intervention in the early identification of RAD and is omitted or is not registered although being prescribed in care plan. Early detection of physiological changes and the identification of patients RAD are need to provide adequate preventive care and treatment and to ensure continued evaluation that avoid deterioration or its consequences.
Clinical trial identification
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All authors have declared no conflicts of interest.