Early warning tools and clinician 'agency' for strengthening safety culture : An integrative review

Aim
Identify and analyse literature investigating nurses' and midwives' use of early warning tools during the care of adult inpatients.

Design
An integrative literature review.

Methods
Whittemore and Knafl's (2005) framework guided this integrative review. PubMed, CINAHL, EMCARE and Google Scholar were systematically searched. The authors assessed the methodological quality of 21 papers meeting inclusion criteria and thematically analysed key data.

Results
Three main themes were identified, each with further sub-themes.

Conclusion
Early warning tools operate within various systems and cultural contexts. However, their potential for improved patient safety may be hindered. Protocols influencing tool usage may make nurses and midwives distanced from patients and their expertise. For early warning tools to enhance patient safety, assessing their integration into practice is crucial to maximizing effectiveness.

Impact
This review emphasizes the importance of integrating human relationships with early warning tools for patient safety.

Patient or Public Contribution
This integrative literature review does not include patient or public input.

Implications for Practice/Policy
Adapting early warning tools to balance standardization for safety and efficiency and promoting nurses' and midwives' expertise and autonomy is required to optimize delivery of quality care and uphold patient safety.

Reporting Method
The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were used.

© 2024 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.