Nursing surveillance of respiratory adverse events among hospitalized adults: A systematic review to guide evidence-based practice

Abstract

Background: Nursing surveillance (NS) involves the purposeful, ongoing acquisition, interpretation, and synthesis of patient data for clinical decision-making. Surveillance is used to identify patients with early signs of distress and prevent adverse events. The processes that support and measure the outcomes of nursing surveillance are not clearly specified.

Aim: The aim of this systematic review was to describe the impact of NS on respiratory adverse events for adult hospitalized patients.

Methods: The PRISMA model guided this systematic search of Academic Search Complete (EBSCOhost), CINAHL Complete (EBSCOhost), Nursing & Allied Health (ProQuest), and PubMed databases for articles published between 1990 and 2019. Search terms included nursing surveillance, data points typically attributed to nursing surveillance, adult hospitalized patients, and adverse respiratory events. The protocol for this review was registered as PROSPERO: CRD42020147557.

Results: Of the 2907 references screened, 67 full-text articles were reviewed and 10 were eligible for inclusion. Research on nursing surveillance in the presence of respiratory deterioration is limited. Six studies used assessment tools that were generated from early warning scores, and four used research or institutionally designed trigger criteria. Surveillance, like other types of nursing care, was difficult to isolate and measure. Although components of surveillance were described in the selected studies, the nurse's role was not explicitly identified. Further research is required to highlight the role nursing surveillance plays in clinical decision-making to keep patients safe.

Linking evidence to action: The attributes of NS provide a useful intervention guide for the hospitalized patient at risk of deterioration. Early warning score techniques provide empirical evidence for identifying patients at risk of deterioration. The findings of this study provide evidence of the significance for research focused on the attributes of NS relative to responding to patients at risk of deterioration.

Keywords: adult health/adult care; evidence-based practice; medical/surgical; nursing practice; patient outcomes; patient safety; quality improvement/quality of care/quality of services.