• M Odell, I J Rechner, A Kapila, T Even, D Oliver, C W H Davies, L Milsom, A Forster, and K Rudman.
• Critical Care Outreach, Department of Intensive Care, Royal Berkshire NHS Foundation Trust, Reading, UK. mandy.odell@royalberkshire.nhs.uk
• Resuscitation. 2007 Sep 1;74(3):470-5.

AimTo determine whether the implementation of a Reading-Modified Early Warning Scoring (R-MEWS) system, is associated with an increased recording of respiratory rate (RR) in hospital inpatients, and whether the presence of a critical care outreach (CCO) service has a further impact on the recording of patient's vital signs.MethodFive annual point prevalence surveys of all adult, non-obstetric acute inpatients (n=2638) in two Hospitals (A and B) were carried out between 2001 and 2005. The R-MEWS system was implemented incrementally in both hospitals to include all study group patients, but a CCO service was only available in Hospital A. Data were collected on numbers of patients, routinely documented physiological observations and R-MEW score.ResultsRespiratory rate (RR) recording increased from 6.0% in the first survey to 77.9% in the last, which correlated with the incremental implementation of the R-MEWS system. Hospital A that had the CCO service showed a greater increase in RR recording than Hospital B with no CCO service.ConclusionThe introduction of an early warning scoring (EWS) was associated with improved respiratory rate recording, which may have been further enhanced by the presence of a CCO service.

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