Document Detail

Into the Night: Factors affecting response to abnormal Early Warning Scores out-of-hours and implications for service improvement.
MedLine Citation:
PMID:  24940567     Owner:  NLM     Status:  In-Data-Review    
Background: Early Warning Scores alert staff to preventable deterioration. Raised scores should lead to escalation of care. Aims: To establish response of staff to patients scoring National Early Warning Score (NEWS) of six or above and to identify patient and environmental factors affecting escalation by nursing staff. Methods: Service evaluation with prospective review of patient records of 118 beds on four medical wards during 20 night-shifts. Results: During 2360 observed bed days 109 patients triggered NEWS >=6 at least once during the observation period. Nursing staff escalated only 18 (17%) of these patients; nearly all of them had predefined chronic health conditions, the majority fulfilled criteria for frailty. Despite their higher 30-day mortality patients with COPD had lower escalation rates. Additionally wards that had more patients with a NEWS >=6 had lower escalation rates. Conclusion: Alarm fatigue and clinical judgement of staff might result in deviation from escalation protocols.
C J Yiu; S U Khan; C P Subbe; K Tofeec; R A Madge
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acute medicine     Volume:  13     ISSN:  1747-4892     ISO Abbreviation:  Acute Med     Publication Date:  2014  
Date Detail:
Created Date:  2014-06-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101553725     Medline TA:  Acute Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  56-60     Citation Subset:  IM    
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