Predictors of clinical deterioration of hospitalized adult medical patients: An integrative literature review protocol

Clinical deterioration of hospitalized medical patients negatively affects patient outcomes and hospital capacity. Failure to recognize and respond promptly to an individual's worsening health status can lead to complications with far-reaching impacts on the patient and family. The ability to identify patient cues that can predict clinical deterioration is an essential role for frontline health-care providers to avert an avoidable health crisis. This protocol is designed to describe an integrative literature review plan that aims to identify, analyze, and synthesize the predictors and associated factors underlying the clinical deterioration of hospitalized medical ward patients. This planned review will follow the methodology of Whittemore and Knafl (2005), which comprises five stages: problem identification, literature search, data evaluation, data analysis, and presentation. CINAHL Plus, Embase, and PubMed databases will be used in the literature search. Primary research studies focusing on the predictors or the associated factors of clinical deterioration among medical ward patients will be eligible for the review. The quality of selected articles will be critically appraised using the Joanna Briggs Institute tools. The process of findings synthesis will be conducted according to Miles and Huberman (1994), which consists of data reduction, data display, data comparison, conclusion drawing, and verification. The findings will be presented as major themes that are supported by the appropriate primary studies.