Belfast Telegraph

Saturday 27 December 2014

Report criticises hospital doctors

Doctors need to spot warning signs of cardiac arrests more speedily, a report says
Doctors need to spot warning signs of cardiac arrests more speedily, a report says

Cardiac arrests in hospitals could be prevented if doctors recognise and act on early warning signs more quickly, a health watchdog has said.

More than a third (38%) of cardiac arrests in acutely ill patients could be avoided by improving their assessment and response to deterioration, researchers finds.

Experts from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) criticised senior doctors for failing their patients by not supporting junior colleagues.

Almost half (47%) of patient assessments when they reached hospital was not good enough, the NCEPOD report shows, and warning signs that a patient was deteriorating and may suffer a cardiac arrest were seen in three-quarters of cases.

The study, Time To Intervene?, finds that warning signs were not picked up in 35% of those patients, not acted on in 56% and not communicated to senior doctors in 55%.

Report author and NCEPOD lead clinical co-ordinator Dr George Findlay said: "The recognition of acute illness, response to it and escalation of concerns to consultants when patients are deteriorating is not happening consistently across hospitals.

"Senior doctors must be involved in the care-planning process for acutely ill patients at an earlier stage and support junior doctors to recognise the warning signs when a patient is deteriorating."

Improved decision-making is also needed for when CPR (cardiopulmonary resuscitation) should be given to a patient and when it should not, known as DNACPR (do not attempt cardiopulmonary resuscitation). Dr Findlay said: "The lack of senior input fails patients by both missing the opportunity to halt deterioration and also by failing to question if CPR will actually improve outcome."

A Department of Health spokesman said: "Assessment and follow-up monitoring of a patient's condition when they are in hospital is obviously a critical part of delivering high-quality patient care. We expect doctors to ensure that patients are assessed effectively on admission and that changes in their condition are closely monitored.

"It is critical that hospitals have processes in place for junior doctors to escalate their concerns to senior colleagues, and for senior doctors to work with junior colleagues on recognising the warning signs of cardiac arrest at an early stage."

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