Signs and symptoms, apart from vital signs, that trigger nurses’ concerns about deteriorating conditions in hospitalized paediatric patients: A scoping review

Abstract

Abstract Aim This scoping review aimed to identify and map the signs and symptoms—apart from vital signs—that trigger nurses’ concerns about the deteriorating conditions of hospitalized paediatric patients. Design A scoping review was conducted in accordance with the Joanna Briggs Institute methodology. Methods Six databases, including MEDLINE, CINAHL, Embase, Scopus, Swemed and ProQuest Dissertations and Theses databases, were searched systematically. Of 5795 citations, seven matched the inclusion criteria. Results Objective observations, such as the patient's colour, pain‐level changes, and behavioural observations, were identified as signs that would trigger nurses’ concerns. Nurse's intuitive feelings or gut feelings when seeing a patient was also identified as an important factor for identifying a deteriorating paediatric patient. A “gut feeling” was described as both a reaction to patient signs and a feeling based on the nurse's intuition gained through experience. The signs or symptoms that would trigger this “gut feeling” were not identified.

Keywords

• clinical deterioration
• early recognition
• nurse intuition
• nursing concern
• pediatric nursing