Night‐time detection and response in relation to deteriorating inpatients: A scoping review

Background Although detection and response to clinical deterioration have been studied, the range and nature of studies focused on night‐time clinical setting remain unclear. Aim This study aimed to identify and map existing research and findings concerning night‐time detection and response to deteriorating inpatients in usual care or research settings. Study Design A scoping review method was used. PubMed, CINAHL, Web of Science, and Ichushi‐Web databases were systematically searched. We included studies focusing on night‐time detection and response to clinical deterioration. Results Twenty‐eight studies were included. These studies were organized into five categories: night‐time medical emergency team or rapid response team (MET/RRT) response, night‐time observation using the early warning score (EWS), available resources for physicians' practice, continuous monitoring of specific parameters, and screening for night‐time clinical deterioration. The first three categories were related to interventional measures in usual care settings, and relevant findings mainly demonstrated the actual situation and challenges of night‐time practice. The final two categories were related to the interventions in the research settings and included innovative interventions to identify at‐risk or deteriorating patients. Conclusions Systematic interventional measures, such as MET/RRT and EWS, could have been sub‐optimally performed at night. Innovations in monitoring technologies or implementation of predictive models could be helpful in improving the detection of night‐time deterioration. Relevance to Clinical Practice This review provides a compilation of current evidence regarding night‐time practice concerning patient deterioration. However, a lack of understanding exists on specific and effective practices regarding timely action for deteriorating patients at night.