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<title>Acutely Ill Patients in Hospital - NCBI Bookshelf</title>
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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE,NOIMAGEINDEX" /><meta name="citation_title" content="Acutely Ill Patients in Hospital" /><meta name="citation_publisher" content="National Institute for Health and Clinical Excellence (NICE)" /><meta name="citation_date" content="2007/07" /><meta name="citation_pmid" content="21204323" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK45947/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Acutely Ill Patients in Hospital" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Institute for Health and Clinical Excellence (NICE)" /><meta name="DC.Date" content="2007/07" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK45947/" /><meta name="description" content="Patients who are admitted to hospital believe that they are entering a place of safety, where they, and their families and carers, have a right to believe that they will receive the best possible care. They feel confident that, should their condition deteriorate, they are in the best place for prompt and effective treatment." /><meta name="og:title" content="Acutely Ill Patients in Hospital" /><meta name="og:type" content="book" /><meta name="og:description" content="Patients who are admitted to hospital believe that they are entering a place of safety, where they, and their families and carers, have a right to believe that they will receive the best possible care. They feel confident that, should their condition deteriorate, they are in the best place for prompt and effective treatment." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK45947/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nicecg50-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/nicecg50/toc/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK45947/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} </style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script>
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/Book"><div class="meta-content fm-sec"><div class="iconblock whole_rhythm clearfix no_top_margin"><a href="http://guidance.nice.org.uk/CG50" title="National Institute for Health and Clinical Excellence (NICE)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nicecg50-lrg.png" alt="Cover of Acutely Ill Patients in Hospital" /></a><div class="icnblk_cntnt"><h1 id="_NBK45947_"><span itemprop="name">Acutely Ill Patients in Hospital</span></h1><div class="subtitle">Recognition of and Response to Acute Illness in Adults in Hospital</div><p><i>NICE Clinical Guidelines, No. 50</i></p><div class="half_rhythm">London: <a href="http://guidance.nice.org.uk/CG50" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Clinical Excellence (NICE)</span></a>; <span itemprop="datePublished">2007 Jul</span>.</div><div><a href="/books/about/copyright/">Copyright</a> © 2007, National Institute for Health and Clinical
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Excellence.</div></div></div></div><div class="body-content whole_rhythm" itemprop="text"><div itemprop="description"><h2>Excerpt</h2><p>Patients who are admitted to hospital believe that they are entering a place of
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safety, where they, and their families and carers, have a right to believe that
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they will receive the best possible care. They feel confident that, should their
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condition deteriorate, they are in the best place for prompt and effective
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treatment.</p><p>Yet there is evidence to the contrary. Patients who are, or become, acutely
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unwell in hospital may receive suboptimal care. This may be because their
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deterioration is not recognised, or because – despite indications of clinical
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deterioration – it is not appreciated, or not acted upon sufficiently rapidly.
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Communication and documentation are often poor, experience might be
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lacking and provision of critical care expertise, including admission to critical
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care areas, delayed.</p><p>We have endeavoured to produce practical guidance with recommendations
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for the measurement and recording of a set of physiological observations,
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linked to a ‘track and trigger’ system (see section 2.1.1). We have emphasised
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the importance of a full clinical assessment, and of tailoring the written
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monitoring and management plans to the individual patient’s clinical
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circumstances. Throughout the document we have emphasised the
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importance of training; by ensuring that routine measurements are accurately
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taken and recorded by staff that understand their clinical relevance, and by
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linking these observations to a graded track and trigger system, care can be
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escalated appropriately. The foundations for patient safety are laid through
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doing and recording simple measurements well and having agreed response
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strategies in place.</p></div><div><h2>Contents</h2><ul id="toc_tllNBK45947_toc_foreword" class="simple-list toc toc-toggle"><li class="half_rhythm" id="toc_itm_NBK45947_toc_foreword"><a class="toc-item" href="/books/n/nicecg50/foreword/">Foreword</a></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_ch1"><a class="toc-item" href="/books/n/nicecg50/ch1/">1. Summary</a><ul id="toc_lst_NBK45947_toc_ch1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK45947_toc_ch1_s1"><a class="toc-item" href="/books/n/nicecg50/ch1/#ch1.s1">1.1. Patient-centred care</a></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_ch1_s2"><a class="toc-item" href="/books/n/nicecg50/ch1/#ch1.s2">1.2. List of recommendations and care pathway</a></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_ch1_s14"><a class="toc-item" href="/books/n/nicecg50/ch1/#ch1.s14">1.3. Overview</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_ch2"><a class="toc-item" href="/books/n/nicecg50/ch2/">2. Evidence review and recommendations</a><ul id="toc_lst_NBK45947_toc_ch2" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK45947_toc_ch2_s1"><a class="toc-item" href="/books/n/nicecg50/ch2/#ch2.s1">2.1. Identification and evaluation of risk scoring tools</a></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_ch2_s24"><a class="toc-item" href="/books/n/nicecg50/ch2/#ch2.s24">2.2. Response strategies for patients identified as having a deteriorating clinical condition</a></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_ch2_s43"><a class="toc-item" href="/books/n/nicecg50/ch2/#ch2.s43">2.3. Transfer of patients from critical care areas</a></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_ch2_s57"><a class="toc-item" href="/books/n/nicecg50/ch2/#ch2.s57">2.4. Research recommendations</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_ch3"><a class="toc-item" href="/books/n/nicecg50/ch3/">3. Methods</a><ul id="toc_lst_NBK45947_toc_ch3" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK45947_toc_ch3_s1"><a class="toc-item" href="/books/n/nicecg50/ch3/#ch3.s1">3.1. Scope and purpose</a></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_ch3_s6"><a class="toc-item" href="/books/n/nicecg50/ch3/#ch3.s6">3.2. Contributors</a></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_ch3_s10"><a class="toc-item" href="/books/n/nicecg50/ch3/#ch3.s10">3.3. Development methods</a></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_ch3_s27"><a class="toc-item" href="/books/n/nicecg50/ch3/#ch3.s27">3.4. Declarations</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_ch4"><a class="toc-item" href="/books/n/nicecg50/ch4/">4. References, glossary and abbreviations</a><ul id="toc_lst_NBK45947_toc_ch4" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK45947_toc_ch4_rl1"><a class="toc-item" href="/books/n/nicecg50/ch4/#ch4.rl1">4.1 Reference list</a></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_glossary"><a class="toc-item" href="/books/n/nicecg50/ch4/#glossary">4.2 Glossary</a></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_abbreviations_gl1"><a class="toc-item" href="/books/n/nicecg50/ch4/#abbreviations.gl1">4.3 Abbreviations</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_appendixes_appgroup1"><a class="toc-item" href="/books/n/nicecg50/appendixes.appgroup1/">Appendices</a><ul id="toc_lst_NBK45947_toc_appendixes_appgroup1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK45947_toc_appendixes_app1"><a class="toc-item" href="/books/n/nicecg50/appendixes.app1/">5.1 Appendix 1. The Scope</a></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_appendixes_app2"><a class="toc-item" href="/books/n/nicecg50/appendixes.app2/">5.2 Appendix 2. Key Clinical Questions</a></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_appendixes_app3"><a class="toc-item" href="/books/n/nicecg50/appendixes.app3/">5.3 Appendix 3. Search Strategies</a></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_appendixes_app4"><a class="toc-item" href="/books/n/nicecg50/appendixes.app4/">5.4 Appendix 4. Evidence Tables</a></li><li class="half_rhythm" id="toc_itm_NBK45947_toc_appendixes_app5"><a class="toc-item" href="/books/n/nicecg50/appendixes.app5/">5.5. Inclusion and Exclusion Criteria</a></li></ul></li></ul></div><div><p>NICE clinical guidelines are recommendations about the treatment and care of people with specific diseases and conditions in the NHS in England and Wales</p><p>This guidance represents the view of the Institute, which was arrived at after careful consideration of the evidence available. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. The guidance does not, however, override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer and informed by the summary of product characteristics of any drugs they are considering.</p></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © 2007, National Institute for Health and Clinical
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Excellence.<p class="small">All rights reserved. This
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material may be freely reproduced for educational and not-for-profit purposes. No
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reproduction by or for commercial organisations, or for commercial purposes, is allowed
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without the express written permission of the Institute.</p></div><div class="small"><span class="label">Bookshelf ID: NBK45947</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/21204323" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">21204323</a></span></div><div style="margin-top:2em" class="bk_noprnt"><div class="pagination bk_noprnt"><span class="inactive page_link prev">< Prev</span><a class="active page_link next" href="/books/n/nicecg50/foreword/" title="Next page in this title">Next ></a></div></div></div></div>
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