Research Article| Volume 26, ISSUE 3, P378-382, June 2019

The meaning of ‘worried’ in MET call activations: A regional hospital examination of the clinical indicator

Published:November 17, 2018DOI:


      Little is known about why nurses escalate a Medical Emergency Team (MET) response based on ‘worried’ criteria or what clinical findings define a ‘worried’ MET call. Limited clarity exists in nursing literature regarding the clinical definition of ‘worried’ in medical emergencies. Commonly ‘worried’ terminology is associated with nursing intuition about a patient’s condition before signs of decline in clinical condition. This research has identified the exact clinical cause of ‘worried’ escalations, with evidence to support that clinical reasoning and patient deterioration are the main cause of ‘worried’ activation. This research has also highlighted areas for further professional development to enhance levels of patient safety and quality care within a regional hospital setting.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Collegian
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Aneman A.
        • Frost S.A.
        • Parr M.J.
        • Hillman K.M.
        Characteristics and outcomes of patients admitted to ICU following activation of the medical emergency team: Impact of introducing a two-tier response system.
        Critical Care Medicine. 2015; 43 (769p): 765-773
        • Benner P.
        From novice to expert.
        • Boniatti M.M.
        • Azzolini N.
        • Viana M.V.
        • Ribeiro B.S.P.
        • Coelho R.S.
        • Castilho R.K.
        • Filho E.M.R.
        Delayed medical emergency team calls and associated outcomes*.
        Critical Care Medicine. 2014; 42 (25p): 26-30
        • Cheevakasemsook A.
        • Chapman Y.
        • Francis K.
        • Davies C.
        The study of nursing documentation complexities.
        International Journal of Nursing Practice. 2006; 12: 366-374
        • Eder S.
        • Sloan E.
        • Todd K.
        Documentation of ED patient pain by nurses and physicians.
        The American Journal of Emergency Medicine. 2003; 21: 253-257
        • Konrad D.
        • Jäderling G.
        • Bell M.
        • Granath F.
        • Ekbom A.
        • Martling C.R.
        Reducing in-hospital cardiac arrests and hospital mortality by introducing a medical emergency team.
        Intensive Care Medicine. 2010; 36 (107p): 100-106
        • Lee T.
        • Goldman L.
        Evaluation of the patient with acute chestpain.
        The New England Journal of Medicine. 2000; 342: 1187-1195
        • Lyneham J.
        • Parkinson C.
        • Denholm C.
        Intuition in emergency nursing: A phenomenological approach.
        International Journal of Nursing Practice. 2008; 14: 101-108
        • Massey D.
        • Aitken L.M.
        • Chaboyer W.
        The impact of a nurse led rapid response system on adverse, major adverse events and activation of the medical emergency team.
        Intensive & Critical Care Nursing. 2015; 31 (88p): 83-90
        • Massey D.
        • Chaboyer W.
        • Aitken L.
        Nurses’ perceptions of accessing a Medical Emergency Team: A qualitative study.
        Australian Critical Care. 2014; 27 (136p): 133-138
        • Miller E.
        • Hill P.
        Intuition in clinical decision making. Differences among practice nurses.
        Journal of Hollistic Nursing. 2017; : 1-11
        • Murray T.
        • Kleinpell R.
        Implementing a rapid response team: Factors influencing success.
        Critical Care Nursing Clinics of North America. 2006; 18 (499p): 493-501
        • Pantazopoulos I.
        • Tsoni A.
        • Kouskouni E.
        • Papadimitriou L.
        • Johnson E.O.
        • Xanthos T.
        Factors influencing nurses’ decisions to activate medical emergency teams.
        Journal of Clinical Nursing. 2012; 21 (2611p): 2668-2678
        • Piquette D.
        • Fowler R.A.
        Do medical emergency teams improve the outcomes of in-hospital patients?.
        CMAJ : Canadian Medical Association Journal = Journal de L'Association Medicale Canadienne. 2005; 173 (592p): 599-600
        • Rothberg M.B.
        • Belforti R.
        • Fitzgerald J.
        • Friderici J.
        • Keyes M.
        Four years’ experience with a hospitalist-led medical emergency team: An interrupted time series.
        Journal of Hospital Medicine. 2012; 7 (106p): 98-103
        • Ruth-Sahd L.
        • Tisdell E.
        The meaning and use of nursing intuition in novice nurses: A phenomenological study.
        American Association for Adult and Continuing Education. 2007; 57: 115-140
        • Saranto K.
        • Kinnunen U.
        Evaluating nursing documentation - research designs and methods: Systematic review.
        Journal of Advanced Nursing. 2009; 65: 464-476
        • Schmid-Mazzoccoli A.
        • Hoffman L.A.
        • Wolf G.A.
        • Happ M.B.
        • Devita M.A.
        The use of medical emergency teams in medical and surgical patients: Impact of patient, nurse and organisational characteristics.
        Quality & Safety in Health Care. 2008; 17 (375p): 377-381
        • Tirkkonen J.
        • Olkkola K.T.
        • Huhtala H.
        • Tenhunen J.
        • Hoppu S.
        Medical emergency team activation: Performance of conventional dichotomised criteria versus national early warning score.
        Acta Anaesthesiologica Scandinavica. 2014; 58 (419p): 411-419
        • Wang N.
        • Hailey D.
        Quality of nursing documenation and approaches to its evaluation: A mixed-method systematic review.
        Journal of Advanced Nursing. 2011; 67: 1858-1875
        • Wong F.
        Chart Audit: Strategies to improve quality of nursing documentation.
        Journal for Nurses in Staff Development. 2009; 25