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. 2021 Jun 15:14:1431-1442.
doi: 10.2147/JMDH.S312395. eCollection 2021.

Effect of National Early Warning Scoring System Implementation on Cardiopulmonary Arrest, Unplanned ICU Admission, Emergency Surgery, and Acute Kidney Injury in an Emergency Hospital, Egypt

Mohamed Naeem Badr  1 , Nahla Shaaban Khalil  1 , Ahmed Mohamed Mukhtar  2
Affiliations

Effect of National Early Warning Scoring System Implementation on Cardiopulmonary Arrest, Unplanned ICU Admission, Emergency Surgery, and Acute Kidney Injury in an Emergency Hospital, Egypt

Mohamed Naeem Badr et al. J Multidiscip Healthc. .

Abstract

Purpose: To evaluate the effect of national early warning scoring system (NEWS) implementation in identifying patients at risk of clinical deterioration at an emergency hospital.

Background: Early warning score has been developed to facilitate early detection of deterioration by categorizing a patients' severity of illness and prompting nursing staff to request a medical review at specific trigger points.

Patients and methods: A prospective, control/intervention groups', quasi-experimental design was utilized. A sample of 364 adult patients were admitted to the inpatient unit at an emergency hospital for six months. The patients were divided into a study group (174 patients) and a control group (190 patients). All study patients were followed up to either death or hospital discharge before and after implementing a new observation chart. The patients' outcomes were compared and analyzed between both groups.

Results: In the intervention period, compared to the control period, a significant reduction was seen in the number of cardiopulmonary arrest (4.7% vs 1.1%, p = 0.046), unplanned ICU admission (5.3% vs 1.7%, p = 0.049), emergency surgery (6.3% vs 0%, p = 0.001), acute kidney injury (6.8% vs 1.1%, p = 0.006). As well, there was a significant increase in the number of patients receiving medical reviews following clinical deterioration in terms of escalation plan (3.2% vs 26.4%, p = <0.001).

Conclusion: The implementation of NEWS was associated with a significant improvement in patients' outcomes in hospital wards, increases in the frequency of vital signs measurements, and an increase in the number of medical reviews following clinical instability.

Keywords: NEWS; clinical deterioration; early warning score; patients’ outcomes.

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Conflict of interest statement

The author reports no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow diagram of patients included.
None
See this image and copyright information in PMC

References

    1. Massey D, Chaboyer W, Anderson V. What factors influence ward nurses’ recognition of and response to patient deterioration? An integrative review of the literature. Nurs Open. 2016;4(1):6–23. doi:10.1002/nop2.53 - DOI - PMC - PubMed
    1. Padilla RM, Mayo AM. Clinical deterioration: a concept analysis. J Clin Nurs. 2018;27(7–8):1360–1368. doi:10.1111/jocn.14238 - DOI - PubMed
    1. Mitchell IA, McKay H, Van Leuvan C, et al. A prospective controlled trial of the effect of a multi-faceted intervention on early recognition and intervention in deteriorating hospital patients. Resuscitation. 2010;81(6):658–666. doi:10.1016/j.resuscitation.2010.03.001 - DOI - PubMed
    1. Connell CJ, Endacott R, Cooper S. The prevalence and management of deteriorating patients in an Australian emergency department. Australas Emerg Care. 2020;S2588-994X(20)30067–1. doi:10.1016/j.auec.2020.07.008 - DOI - PubMed
    1. Mok WQ, Wang W, Liaw SY. Vital signs monitoring to detect patient deterioration: an integrative literature review. Int J Nurs Pract. 2015;21(Suppl 2):91–98. doi:10.1111/ijn.12329 - DOI - PubMed