Martha's Rule

What is Martha’s Rule?

We have introduced Martha’s Rule to help spot any unexpected signs of deterioration early and give you the right to request a rapid review if you’re worried that your or your loved one’s condition is getting worse. You may notice small changes before they show up in our routine measurements. These changes could be early warning signs of deterioration.

You are not bothering us - we want to hear from you.

How we monitor patients

While someone is in hospital, we regularly check their vital signs and other important health measurements. The frequency of these checks will depend on the patient’s individual condition and needs. Sometimes we may need to wake patients to do these checks. In addition, we will ask at least daily if they are feeling better or worse. This is to monitor any unexpected changes in their condition.

Your role is vital

To help us detect the early signs of deterioration, please tell us if you are worried about:

Adults	Children
Changes in temperature – hot or cold to the touch Worsening pain Any changes to the skin (e.g. rash) Low energy, drowsy or sleepy Levels of hydration Changes in breathing New confusion Anything else that worries you	Has a temperature – sweating or hot or cold to the touch Has a high pitched or abnormal cry Has any changes to the appearance of their skin (pale, rash or sores/blisters) Is less responsive or floppy, difficult to wake Is irritable and will not settle Is not interested in feeding / drinking or eating Is breathing faster than normal, grunting with each breath or wheezing Is weeing much less or has blood in their poo Anything else that worries you

Adults

Children

Changes in temperature – hot or cold to the touch
Worsening pain
Any changes to the skin (e.g. rash)
Low energy, drowsy or sleepy
Levels of hydration
Changes in breathing
New confusion
Anything else that worries you

Has a temperature – sweating or hot or cold to the touch
Has a high pitched or abnormal cry
Has any changes to the appearance of their skin (pale, rash or sores/blisters)
Is less responsive or floppy, difficult to wake
Is irritable and will not settle
Is not interested in feeding / drinking or eating
Is breathing faster than normal, grunting with each breath or wheezing
Is weeing much less or has blood in their poo
Anything else that worries you

Telling our staff about these changes can help us to detect deterioration early so we can take action to prevent more serious health problems.

What to do if you’re worried

First, speak to the team caring for you or your loved one.
If, after speaking to the care team, you remain worried and feel your concerns are not being addressed, call for a rapid review.

Call 07779 858763

Your call will go to a different team in our hospital, who specialise in the care of critically ill patients. They will work with you and your care team to arrange any treatment needed or further review.

The service is available 24 hours a day, seven days a week.

Our commitment

We will regularly ask for your views and take your concerns seriously. We see you as a partner in the care we are providing and want you to raise any worries and concerns you may have.