Early warning tools and clinician ‘agency’ for strengthening safety culture: An integrative review.

Aim Design Methods Results Conclusion Impact Patient or Public Contribution Implications for Practice/Policy Reporting Method Identify and analyse literature investigating nurses' and midwives' use of early warning tools during the care of adult inpatients.An integrative literature review.Whittemore and Knafl's (2005) framework guided this integrative review. PubMed, CINAHL, EMCARE and Google Scholar were systematically searched. The authors assessed the methodological quality of 21 papers meeting inclusion criteria and thematically analysed key data.Three main themes were identified, each with further sub‐themes.Early warning tools operate within various systems and cultural contexts. However, their potential for improved patient safety may be hindered. Protocols influencing tool usage may make nurses and midwives distanced from patients and their expertise. For early warning tools to enhance patient safety, assessing their integration into practice is crucial to maximizing effectiveness.This review emphasizes the importance of integrating human relationships with early warning tools for patient safety.This integrative literature review does not include patient or public input.Adapting early warning tools to balance standardization for safety and efficiency and promoting nurses' and midwives' expertise and autonomy is required to optimize delivery of quality care and uphold patient safety.The Preferred Reporting Items for Systematic Reviews and Meta‐analyses guidelines were used. [ABSTRACT FROM AUTHOR]