Fig. 2

Visual representations of the relationships observed in the high-dependency units of Elizabeth Queen Central Hospital and Zomba Central Hospital and the actions taken by nurses once they identify deterioration. a Relationship map between stakeholders caring for patients admitted to the HDU. Arrows and text in blue indicate the main type(s) of interactions observed. b Nurses’ action map, response to deterioration. The green box on the left contains the means used to record/generate medical information (sources of clinical information) which is used by nurses. Arrows and text in green indicate the type of information used by nurses to identify deterioration. The red box on the right contains the different possible actions taken by nurses after identifying deterioration (arrows and text in red)