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Do clinical trigger questions leave room for nursing judgment?

  • Comments (2)


Carberry M et al (2014) Early warning systems 2: ward nurses’ perceptions of clinical trigger questions. Nursing Times; 109: 1/3, 15-17.


“This service evaluation was conducted in three acute hospitals to ascertain ward nurses’ thoughts on clinical trigger questions used to identify sick patients.

“Trigger questions were added to early warning scoring systems to help nurses identify and hand over sick patients. After the questions were introduced, all nurses (n = 633) working in acute wards of three district general hospitals were sent an anonymous questionnaire. Analysis was completed using descriptive statistics.

“The response rate was 61.4% (n = 389). Most (56.9%) respondents thought the questions changed their perception of what makes a patient at risk of deterioration, 85.7% thought they helped identify sick patients and 87.5% thought they improved referral.

“Nurses felt clinical trigger questions helped them identify ill patients. Such questions could be used as a clinical framework for escalation and referral, and to support ward staff in identifying patients whose health is deteriorating.”


What do you think?

What do you think of clinical trigger questions?

Does this type of assessment leave enough room for your own judgement?

Which areas of nursing would benefit from this tool?

  • Comments (2)

Readers' comments (2)

  • Anonymous

    The questions posed seem reasonable and if they help identify those patients who may not initially be highlighted as unwell then using them can only be a good thing.

    Virtually every aspect of nursing is now governed by a flow chart, standard, ridiculously-acronymed pathway or booklet so a nurse not being allowed to use her own judgment is nothing new.

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  • Anonymous

    We don't appear to encourage use of judgement, hence the need for tools. Or we have become so reliant on tools, that we are unable to use our judgement. Either way, there is a danger that tools and flow charts are becoming more important than patient observation, history taking, communication, etc. Evidence-based practice is vital, but so are other skillls. Balance is getting harder to achieve.

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