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Aims: To explore and summarise the literature on the concept of 'clinical deterioration' as a nurse‐sensitive indicator of quality of care in the out‐of‐hospital context. Design: The scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Extension for Scoping Review and the JBI best practice guidelines for scoping reviews. Methods: Studies focusing on clinical deterioration, errors of omission, nurse sensitive indicators and the quality of nursing and midwifery care for all categories of registered, enrolled, or licensed practice nurses and midwives in the out‐of‐hospital context were included regardless of methodology. Text and opinion papers were also considered. Study protocols were excluded. Data Sources: Data bases were searched from inception to June 2022 and included CINAHL, PsychINFO, MEDLINE, The Allied and Complementary Medicine Database, EmCare, Maternity and Infant Care Database, Australian Indigenous HealthInfoNet, Informit Health and Society Database, JSTOR, Nursing and Allied Health Database, RURAL, Cochrane Library and Joanna Briggs Institute. Results: Thirty‐four studies were included. Workloads, education and training opportunities, access to technology, home visits, clinical assessments and use of screening tools or guidelines impacted the ability to recognise, relay information and respond to clinical deterioration in the out‐of‐hospital setting. Conclusions: Little is known about the work of nurses or midwives in out‐of‐hospital settings and their recognition, reaction to and relay of information about patient deterioration. The complex and subtle nature of non‐acute deterioration creates challenges in defining and subsequently evaluating the role and impact of nurses in these settings. Implications for the profession and/or patient care: Further research is needed to clarify outcome measures and nurse contribution to the care of the deteriorating patient in the out‐of‐hospital setting to reduce the rate of avoidable hospitalisation and articulate the contribution of nurses and midwives to patient care. Impact: What Problem Did the Study Address?: Factors that impact a nurse's ability to recognise, relay information and respond to clinical deterioration in the out‐of‐hospital setting are not examined to date. What Were the Main Findings?: A range of factors were identified that impacted a nurse's ability to recognise, relay information and respond to clinical deterioration in the out‐of‐hospital setting including workloads, education and training opportunities, access to technology, home visits, clinical assessments, use of screening tools or guidelines, and avoidable hospitalisation. Where and on whom will the research have an impact? Nurses and nursing management will benefit from understanding the factors that act as barriers and facilitators for effective recognition of, and responding to, a deteriorating patient in the out‐of‐hospital setting. This in turn will impact patient survival and satisfaction. Reporting Method: The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Extension for Scoping Review guidelines guided this review. The PRISMA‐Scr Checklist (Tricco et al., 2018) is included as (supplementary file 1).Data sharing is not applicable to this article as no new data were created or analysed in this study." No Patient or Public Contribution: Not required as the Scoping Review used publicly available information. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to codesign a Family Members' Voice Reorientation Intervention (FAMVR) for delirium prevention and management in critically ill adult patients through collaborative process with previous patients, families, and clinical staff., Background: Delirium is a common consequence of intensive care admission, and there is limited evidence to support family-led interventions to prevent or minimise delirium in intensive care. People with lived experience of intensive care are seldom involved in codesigning delirium prevention and management interventions despite the identified benefits of their involvement in delirium care., Design: Codesign qualitative study., Methods: The process of co-designing was undertaken using the four stages of the Double Diamond model. Participants included people with lived experience of the intensive care unit, family members, and intensive care clinicians. The codesign approach was utilised, and data were gathered from a series of focus groups and individual interviews. Data were digitally recorded, transcribed verbatim, and analysed using thematic analysis., Findings: Of the 26 people who indicated their interest in participating, 12 (46%) completed the first and second stages, and nine (35%) completed the third and fourth stages of the Family Members' Voice Reorientation Intervention development. All participant groups were represented in the fourth stage: patients (n = 4), family members (n = 1), nurses (n = 2), and medical staff (n = 2). Four themes were identified: message content, wording, reactions, and tone, all of which informed the prototype of the intervention and its associated domains., Conclusion: A codesign approach was important for developing a delirium management intervention. This process enabled participants to provide their feedback in the context of their unique experiences, which in turn enhanced the authenticity and appropriateness of this unique intervention., (Copyright © 2024 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)