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Nurs Crit Care. 2002 Sep-Oct;7(5):215-9.

An audit of a patient-at-risk trigger scoring system for identifying seriously ill ward patients.

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  • 1Intensive Care Unit, University Hospital Lewisham, London.


The Lewisham patient-at-risk trigger scoring system (PAR-T) comprises an early warning 'trigger' system, designed to identify adult patients at risk of developing critical illness at an early stage, and a protocol to use for those patients identified. PAR-T was trialled on five acute ward areas in the trust. The aims were to evaluate the effectiveness of the scoring system as an early identification tool, the benefit of the flow chart protocol and the outcomes of those patients who were identified. Other issues explored during the audit were severity of illness amongst different groups of patients, management of chronically seriously ill patients and related organisational issues. The audit confirmed that PAR-T is a sensitive tool for identifying critical illness. Therefore, it was recommended that PAR-T be introduced on a wider scale in the trust, so that its sensitivity and specificity could be analysed further, particularly with regard to establishing the most sensitive markers of critical illness.

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