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Failure to rescue is a major cause of mortality in acute care settings. Several factors contribute to this problem, and nurses hold a significant key to addressing the issue. Using bell curves to analyze patient assessment data enables nurses to recognize indicators of impending crisis and act expediently to safeguard the health of the patient.
Failure to rescue (FTR), which is rapidly becoming a national health care crisis, is the "inability of clinicians to save a patient's life by timely diagnosis and treatment when a complication develops" (Gephart, McGrath, & Effken, 2011, p. 275). Patients display signs and symptoms of impending arrest as early as 72 hours prior to the arrest (Subbe & Welch, 2013). Failure to rescue occurs when health care providers do not recognize these signs and symptoms and subsequently fail to take appropriate action to stabilize the patients.
According to Moldenhauer, Sabel, Chu, and Mehler (2009), four impediments to recognition and intervention for clinical deterioration are: "(a) failure to recognize clinical deterioration; (b) failure to communicate and escalate concerns; (c) failure to physically assess the patient; and (d) failure to diagnose and treat appropriately" (p. 165). AlQahtani and Al-Dorzi (2010) offered other possibilities, including organizational failure, provider lack of knowledge and failure to realize clinical injury, lack of supervision, and failure to get advice. Nurses have immense opportunities to impact these areas of weakness within organizations because they form the hub of personalized health care (Friese & Aiken, 2008). However, "nurses contribute to failure to rescue events when they do not recognize, act on, or report the signs of clinical deterioration" (Schubert, 2012, p. 467).
Nurses can implement four activities to prevent FTR events: (a) surveillance, (b) timely identification of complications, (c) taking action, and (d) activating a team response (Gephart et al., 2011). They must be able to complete thorough assessments, critically think about the findings, and take appropriate action to initiate a team response; that is, they must implement clinical judgment. A key question nurses should consider when identifying changes in assessment is, "Is this change benign or pathological?" Some early assessment findings in a deteriorating patient are very subtle and may be attributed easily to benign causes. However, nurses should consider changes in cardiac output and hypoxia as...