More than one in five nurses lack confidence in their colleagues’ ability to spot a deteriorating patient.
Twenty-two per cent of respondents to Nursing Times’s online survey said they were not confident that the staff on their ward who carry out observations were able to identify significant changes in a patient that might indicate their condition was worsening.
More than one third - 35% - said patient observations had got worse over the last year, with the majority saying that was due to staffing levels.
More than half knew of at least one incident in the past month where a patient’s condition had got worse because staff had failed to notice deterioration.
The most commonly cited reasons for these incidents were a lack of staff, inexperienced employees and staff being “too busy”.
The use of technology was also flagged as a cause of worsening standards in observations with more than half of respondents saying digital observation technology made nurses less likely to be able to identify signs of deterioration by themselves.
The survey also suggested that in 17% of wards, few or none of the staff responsible for using patient observation technology had been trained to use it.
Heart of England Foundation Trust corporate nurse at Jo Richmond said the use of technology could distract from the basics of nursing.
She told Nursing Times: “My biggest concern is that it doesn’t tell you if the pulse is irregular or has poor volume, or if the patient’s skin is clammy.”
To ensure observations are thorough, the National Patient Safety Agency has recommended that every trust should have a deterioration recognition group. However, only a quarter of respondents knew about such a group at their trust.
Ms Richmond said her trust had a multidisciplinary group, which set small targets to improve patient safety based on audits of nurses’ observations.
“The important thing is we have got intelligence on the ground to tell us whether our charts are being filled in and observations being done,” she said.
Medway Foundation Trust director of nursing Jacqueline McKenna said her trust was seeing a “turning point” in improving its observations thanks to its deterioration recognition group. She said: “It’s about having good policy, training and education and constant audit.”
Nursing Times ran a similar survey in October 2009. Then, 9% of respondents said they were not confident staff on their ward could carry out observations with competence, compared with 22% this month. However, our anonymous surveying method means that comparisons are not reliable.
Hospital staff miss danger signs in deteriorating patients