By Tom Andrews, RN, B.Sc. (Hons), M.Sc., Ph.D. & Heather Waterman, RN, B.Sc. (Hons), Ph.D. Abstract The research aims were to investigate the difficulties ward staff experienced in detecting deterioration and how these were resolved. The emphasis within the literature tends to be on identifying premonitory signs that may be useful in predicting deterioration. Changes in respiratory rate is the most consistent of these (Fieselmann et al. 1993; Sax and Charlson 1987; Schein et al. 1990; Smith and Wood 1998) but in common with other signs, it lacks sensitivity and...