Recognising and responding to acute illness in adults in hospital: summary of NICE guidance

Patients in hospital are at risk of becoming acutely ill due to their underlying diagnosis, associated comorbidities, and increasing age and the increasing complexity of care delivered in our hospitals. The recognition of deteriorating health by clinical staff is often delayed or managed inappropriately, resulting in late referral to critical care, avoidable intensive care admissions, and many unnecessary patient deaths.1 This article summarises the most recent guidance from the National Institute for Health and Clinical Excellence (NICE) on improving the recognition and response to acute illness in adults in hospital.2 NICE recommendations are based on systematic reviews of best available evidence. When minimal evidence is available, a range of consensus techniques is used to develop recommendations. In this summary, recommendations derived primarily from consensus techniques are indicated with an asterisk (*). ### Initial assessment Adult patients in acute hospital settings, including patients in the emergency department for whom a clinical decision to admit has been made, should have: Staff undertaking these procedures should be trained to record these observations, understand their clinical relevance, and act upon them.* As a minimum, the following physiological observations should be recorded at the initial assessment and as part of routine monitoring:* ### Routine monitoring