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Open Access 01-12-2019 | Care | Protocol

Patient and family-initiated escalation of care: a qualitative systematic review protocol

Authors: Aidín McKinney, Donna Fitzsimons, Bronagh Blackwood, Jennifer McGaughey

Published in: Systematic Reviews | Issue 1/2019

Abstract

Background

Despite the introduction of rapid response systems and early warning scores, clinical deterioration that is not recognised or responded to early enough prevails in acute care areas. One intervention that aims to address this issue and that is gaining increased attention is patient- and family-initiated escalation of care schemes. Existing systematic review evidence to date has tended to focus on identifying the impact or effectiveness of these schemes in practice. However, they have not tended to focus on qualitative evidence to consider the experience of deterioration and the factors that may promote or hinder engagement with these schemes in the practice setting. This systematic review will address this gap. The aim of this review is to explore patients’, relatives’ and healthcare professionals’ experiences of deterioration and their perceptions of the barriers or facilitators to patient and family-initiated escalation of care in acute adult hospital wards.

Methods

We will search Medline, CINAHL, Embase and PsycINFO databases using free-text and MESH terms relating to deterioration, family-initiated rapid response, families, patients, healthcare staff, hospital and experiences. We will search grey literature and reference lists of included studies for further published and unpublished literature. All studies with a qualitative design or method will be included. Two reviewers will independently assess studies for eligibility, extract data and appraise the quality of included studies. Data will be synthesised using a thematic synthesis approach, and findings will be presented narratively.

Discussion

Patient- and family-initiated escalation of care schemes have been developed and implemented in several countries including the United States, the United Kingdom and Australia, but there is limited evidence regarding patients’ or families’ perceptions of deterioration or the barriers and facilitators to using these schemes in practice, particularly in acute adult areas. This systematic review will provide evidence for the development of a patient and family escalation of care scheme that can be tested in a feasibility study.

Systematic review registration

PROSPERO CRD42018106952

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McKinney A, Fitzsimons D, Blackwood B, McGaughey J. Patients’, relatives’ and healthcare professionals’ experiences of deterioration and their perceptions of the barriers and facilitators to patient and family-initiated escalation of care in acute adult general hospital wards: a qualitative systematic review protocol. PROSPERO 2018 CRD42018106952 Available from: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018106952. Accessed 15 Nov 2018

Title: Patient and family-initiated escalation of care: a qualitative systematic review protocol
Authors: Aidín McKinney
Donna Fitzsimons
Bronagh Blackwood
Jennifer McGaughey
Publication date: 01-12-2019
Publisher: BioMed Central
Keyword: Care
Published in: Systematic Reviews / Issue 1/2019
Electronic ISSN: 2046-4053
DOI: https://doi.org/10.1186/s13643-019-1010-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Patient and family-initiated escalation of care: a qualitative systematic review protocol

Abstract

Background

Methods

Discussion

Systematic review registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Discussion

Systematic review registration

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