Abstract
The evidence base concerning the vulnerability of the deteriorating patient has been built over a period of two decades or more (Schein et al, 1990; Franklin and Mathew, 1994; McQullian et al, 1998; Department of Health (DH), 2000). In addition, the Audit Commission (1999) reported on the need for a system of early detection of a patient at risk of deteriorating and in likely need of specialist critical care services. For many acute NHS trusts within the UK, a move towards a system of early detection and a focused support system for ward-based clinical staff has been commonplace with the evolution of early warning scoring (EWS) systems and the critical care outreach team.
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