Exploring REsponse to clinical Deterioration out-of-HOURS (RED-HOURS)

The Acute and Critical Care Research Group at the School of Health and Medical Sciences, City St George's, University of London welcome Misha Denise Virtudazo from the Chelsea and Westminster Hospital NHS Foundation Trust to discuss nursing staff recognition and escalation of clinical deterioration out-of-hours, as part of the SHMS research seminar series.

Abstract

Clinical deterioration remains a patient safety challenge, with evidence consistently demonstrating poorer patient outcomes out-of-hours. Patients admitted to hospital, undergoing procedures, or clinical deteriorating during nights and weekends have higher mortality than those receiving care in-hours (Monday-Friday 0900-17:59). However, while determinants of recognising and escalating deterioration have been widely explored, it remains unclear whether these factors are the same within the distinct context of out-of-hours care.

This presentation will take you through the programme of work underpinning Misha's NIHR doctoral fellowship, from a mixed-methods systematic review and theory-informed qualitative study exploring nursing staff recognition and escalation of clinical deterioration out-of-hours, to the development of her PhD proposal. The presentation will highlight key findings, discuss their implications for practice, and outline future research aimed at improving care for deteriorating patients out-of-hours.

About the Speaker

Misha Denise Virtudazo is a Consultant Nurse, Critical Care Outreach Lead at Chelsea and Westminster Hospital NHS Foundation Trust. She was recently granted an NIHR Doctoral Clinical Academic Fellowship, where she will explore the behavioural, organisational, and system-level factors that influence how deterioration is recognised and escalated in acute hospital settings. Misha combines clinical practice with research to develop evidence-informed interventions that support safer care for deteriorating patients and strengthen the nursing contribution to patient safety.