Implementation of the Deterioration Index: a Benchmark Study

With Intensive Care Unit (ICU) and Emergency Department (ED) beds extremely limited during this pandemic, it is time to implement an automated early warning scoring index to assist nurses in identifying clinical deterioration prior to the patient becoming clinically unstable. The goal of using this risk score is early identification of clinical deterioration, with early intervention, and thereby decreasing cardiac arrests outside of the ICU and decreasing unplanned ICU admissions. There are multiple early warning scoring tools, but they all serve one purpose, to calculate a score based upon nursing and physician assessments, lab values, and medical history that will prompt the staff to act prior to a devastating event (Pederson et al., 2015). The early warning score provides a defined set of data that aids in clear communication among care providers. Evidence shows that many patients exhibit elevated deterioration scores up to 24 - 48 hours prior to a significant event requiring rapid intervention, with approximately 40% of ICU admits being unavoidable (Gagne & Fetzer, 2018; Smith et al., 2014). Early recognition of these changes in patient condition is key to early intervention, which can improve patient outcomes (Parrish et al., 2017).This project focuses on the implementation of the Deterioration Index (DI) scoring system within Epic and how it will affect patient outcome and transfers to the ICU. It will identify nurses\u27 knowledge of the tool, provide personalized education of the tool based upon results through the Nursing Education & Professional Development team, and then implement usage of the tool