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. 2025 Aug 21:17:215-232.
doi: 10.2147/OAEM.S521517. eCollection 2025.

Effect of an Educational Intervention on Nurses' Knowledge Regarding Use of Modified Early Warning Score in Recognition of Critical Illness

Samuel Olowo  1   2 , Rachel Luwaga  1 , Vallence Niyonzima  1
Affiliations

Effect of an Educational Intervention on Nurses' Knowledge Regarding Use of Modified Early Warning Score in Recognition of Critical Illness

Samuel Olowo et al. Open Access Emerg Med. .

Abstract

Background: Nurses miss recognizingalterations in patients' conditions despite charting. This is due to a lack of knowledge and understanding of deterioration. The modified early warning score (MEWS) aids nurses in early recognition of and response to clinical deterioration. However, utilization of MEWS remains a major challenge at Mulago Hospital, where approximately 63.2% of in-hospital cardiac arrests remain unrecognized. This has resulted in a significant burden of critical illness, with a prevalence of 11.7% and mortality rate of 5.5%. Mulago Hospital-medical and surgical wards showed limited documentation of nurses' use of the MEWS. This study assessed the effect of an educational intervention on nurses' knowledge of the use of MEWS to recognize critical illnesses at the Mulago Hospital.

Methods and materials: A descriptive, quantitative, quasi-experimental one-group pretest-posttest design was employed. A convenience sample of 77 nurses from the Medical and Surgical units of Mulago National Referral Hospital participated. Nurses received face-to-face teaching on the Modified Early Warning Score (MEWS). Data were collected using a validated self-administered questionnaire, with pre-intervention data gathered two weeks before and post-intervention data one month after the training. The Wilcoxon signed-rank test was used to evaluate the effect of the intervention on nurses' knowledge of MEWS, with significance set at p < 0.05 and a 95% confidence interval.

Results: The educational intervention led to a significant improvement in nurses' knowledge of the Modified Early Warning Score (MEWS), as evidenced by a Wilcoxon signed-rank test result of Z = 7.631 (p < 0.0001). Prior to the intervention, the majority of participants (67.53%, n = 52) demonstrated a novice level of MEWS knowledge. The study sample consisted predominantly of female nurses (67.53%, n = 52), with most participants (75.32%, n = 58) aged over 30 years. The mean age was 36.78 ± 8.21 years.

Conclusion: Nurses' baseline knowledge of the nurses towards MEWS was low. Educational interventions significantly improved nurses' knowledge toward modified early warning scores in the recognition of critical illness.

Keywords: Mulago; Uganda; knowledge; modified early warning score; nurse.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

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Study profile.
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