STAR” specific-triage–active-response model-triage level of care in recognizing and responding to clinical deterioration in community nursing service: pilot project 01/01/2015 31/12/2015 community nursing service (CNS) provides continuous care to discharged patients to ensure optimal health maintenance and stay safety in the community.Cognitive view of learning definition clinical deterioration with a sharp recognizes and effective triage actions are indeed essential in community nurses (cns). Hence, CNS has developed a “STAR”- specific triage active response model to early identify and timely intervention for the deterioration risk of referred patients so as to foster timely recognition and ensure treatment in an appropriate level of care.Cognitive view of learning definition through the structured triage system which works with understanding and practice of cns will be referred the risky patients with clinical deterioration, the aims are to optimal utilization of health care facilities and reduce unnecessary emergency admission so as to reduce harm to patients from failures to recognize and respond to clinical deterioration for the appropriate health care facilities. (1)to develop a “level-of-clinical deterioration” triage tool to recognize discharged patients’ sign of deterioration and appropriate action (2)to explore the efficiency of implementing the community nurses as a role for “level- of-clinical deterioration” categorization. (3)to explore the effectiveness of the implementation of “level-of-clinical deterioration” in community nursing service this is a prospective cohort study conducted in kowloon east cluster CNS since 2015.Cognitive view of learning definition community nurses (cns) triaged for the patients whose were found clinical sign of deterioration on their physical condition to receive timely treatment according to the “level of clinical deterioration”.Cognitive view of learning definition the sign of deterioration will be categorized at four levels, from low risk to very high risk, according to patients’ sign of physical deterioration and the responses for triaging the appropriate health-care facilities.Cognitive view of learning definition the four levels-of-clinical deterioration have different components of sign namely deviated-base-line sign, alert sign, serious sign and critical sign with physiological parameters and symptoms to indicate level of severity deterioration and related interventions.Cognitive view of learning definition the compliance rate and staff satisfaction survey was conducted after one year implementation and analyzed. Overall 93% of eighty-eight staff agreed the clinical sign of deterioration and interventions described in the “STAR” model are provided as concise and basic physiological parameters guidance.Cognitive view of learning definition the staff showed a very positive response to this model which provides valuable information for communication between cns. The utilization rate of “STAR” model was 86.4% in the past one year nearly 100% of patients could be timely triaged to the appropriate health care facilities including close monitoring and telephone support, home visit next day /private doctor /out-patient clinic, advanced medical follow up /accident and emergency department and urgent call ambulance according to the signs of deterioration.Cognitive view of learning definition the result showed that there was 69% of “STAR” model to categorize the patient to level I. Furthermore, the “STAR” model is a useful risk stratification tool to early identification of the patients’ needs and timely interventions conclusion the STAR"" model is effective to identify and manage clinical sign of deterioration patients who require timely and appropriate interventions.Cognitive view of learning definition it also provides valuable information for communication and staffing among community nurses who act as gate keeper between hospital and community services and serves as facilitators and coordinators of discharged patients.Cognitive view of learning definition