Journal of nursing care quality
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The modified early warning system (MEWS) is a scoring rubric used to detect the earliest signs of a change in a patient's condition. This mixed-methods study used pre- and postintervention data to describe the impact of the MEWS on the frequency of rapid response system activations and cardiopulmonary arrests among patients admitted to medical-surgical units. Focus groups of nursing staff provided insight into the factors that influence how nurses use the MEWS at the bedside as a framework to identify, intervene, and manage patients in need of an advanced level of care.
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Early warning scores calculated by registered nurses (RNs) are used in hospitals to enhance the recognition of and communication about patient deterioration. This study evaluated workflow variables surrounding calculation and documentation of one pediatric hospital's use of an early warning score. Results indicated that there were significant delays in documentation of early warning scores by RNs and inconsistencies between the early warning scores and vital signs collected and documented by non-RN personnel. These findings reflected information obtained from the RNs about how they prioritize tasks and use work-arounds to specific systems issues regarding assessment and documentation in the electronic medical record.