scholarly journals Evaluasi Penerapan Early Warning Score di Ruang Rawat Inap Dewasa

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Sri Wulan Megawati ◽  
Raden Siti Jundiah ◽  
Nur Intan Hayati Husnul Khotimah ◽  
Rizki Muliani
Keyword(s):  
Patient Outcomes ◽  
Early Warning ◽  
Demographic Data ◽  
Monitoring And Evaluation ◽  
Patient Characteristics ◽  
Early Warning Score ◽  
Patient Handling ◽  
Observational Cohort ◽  
Subsequent Patient ◽  
Score Evaluation

Early Warning Score (EWS) is one of the instruments used to assess the patient's physiological deterioration and is one of the assessments in hospital accreditation. The application of the EWS can predict patient outcomes in the form of mortality, length of stay, and re-hospitalization. The purpose of this study was to evaluate the application of EWS in the inpatient room. This study was a prospective observational cohort study of patients in adult wards (≥16 years) over a while (1 month). The number of samples was 256 patients. The instruments used in this study were a demographic data questionnaire and an EWS observation sheet. Descriptive statistics were used for patient characteristics, and EWS monitoring documents. The results showed that 100% of the EWS sheet documentation was incomplete, if this examination sheet was not carried out correctly it would affect the subsequent patient handling and patient outcomes both related to illness and death. Monitoring and evaluation related to the implementation of the EWS are very much needed in the future for the improvement of hospital services as a whole. Keywords: Early Warning Score, Evaluation

scholarly journals Data-driven approach to Early Warning Score-based alert management

2018 ◽  
Vol 7 (3) ◽  
pp. e000088 ◽  
Author(s):  
Muge Capan ◽  
Stephen Hoover ◽  
Kristen E Miller ◽  
Carmen Pal ◽  
Justin M Glasgow ◽  
...  
Keyword(s):  
Patient Safety ◽  
Early Warning ◽  
Early Recognition ◽  
Clinical Information ◽  
Patient Characteristics ◽  
The Elderly ◽  
Early Warning Score ◽  
The Right ◽  
The Impact ◽  
Alerting Systems

BackgroundIncreasing adoption of electronic health records (EHRs) with integrated alerting systems is a key initiative for improving patient safety. Considering the variety of dynamically changing clinical information, it remains a challenge to design EHR-driven alerting systems that notify the right providers for the right patient at the right time while managing alert burden. The objective of this study is to proactively develop and evaluate a systematic alert-generating approach as part of the implementation of an Early Warning Score (EWS) at the study hospitals.MethodsWe quantified the impact of an EWS-based clinical alert system on quantity and frequency of alerts using three different alert algorithms consisting of a set of criteria for triggering and muting alerts when certain criteria are satisfied. We used retrospectively collected EHRs data from December 2015 to July 2016 in three units at the study hospitals including general medical, acute care for the elderly and patients with heart failure.ResultsWe compared the alert-generating algorithms by opportunity of early recognition of clinical deterioration while proactively estimating alert burden at a unit and patient level. Results highlighted the dependency of the number and frequency of alerts generated on the care location severity and patient characteristics.ConclusionEWS-based alert algorithms have the potential to facilitate appropriate alert management prior to integration into clinical practice. By comparing different algorithms with regard to the alert frequency and potential early detection of physiological deterioration as key patient safety opportunities, findings from this study highlight the need for alert systems tailored to patient and care location needs, and inform alternative EWS-based alert deployment strategies to enhance patient safety.

The impact of the use of the Early Warning Score (EWS) on patient outcomes: A systematic review

Resuscitation ◽  
2014 ◽  
Vol 85 (5) ◽  
pp. 587-594 ◽  
Author(s):  
N. Alam ◽  
E.L. Hobbelink ◽  
A.J. van Tienhoven ◽  
P.M. van de Ven ◽  
E.P. Jansma ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Outcomes ◽  
Early Warning ◽  
Early Warning Score ◽  
The Impact

scholarly journals Using modified early warning score to predict need of lifesaving intervention in adult non-trauma patients in a tertiary state hospital

2018 ◽  
Vol 25 (3) ◽  
pp. 146-151 ◽  
Author(s):  
Leong Shian Peng ◽  
Azhana Hassan ◽  
Aida Bustam ◽  
Muhaimin Noor Azhar ◽  
Rashidi Ahmad
Keyword(s):  
Emergency Department ◽  
Critically Ill ◽  
Early Warning ◽  
Demographic Data ◽  
Vital Signs ◽  
Multivariate Logistic Regression Analysis ◽  
Early Warning Score ◽  
Trauma Patients ◽  
Multivariate Logistic Regression ◽  
Level Of Consciousness

Background: Modified early warning score has been validated in many uses in the emergency department. We propose that the modified early warning score performs well in predicting the need of lifesaving interventions in the emergency department, as a predictor of patients who are critically ill. Objective: The study aims to evaluate the use of modified early warning score in sorting out critically ill patients in the emergency department. Methods: The patients’ demographic data and first vital signs (blood pressure, heart rate, temperature, respiratory rate, and level of consciousness) were collected prospectively. Individual modified early warning score was calculated. The outcome was a patient received one or more lifesaving interventions toward the end of stay in emergency department. Multivariate logistic regression analysis was utilized to assess the association between modified early warning score and other potential predictors with outcome. Results: There are a total of 259 patients enrolled into the study. The optimal modified early warning score in predicting lifesaving intervention was ≥4 with a sensitivity of 95% and specificity of 81%. Modified early warning score ≥4 (odds ratio = 96.97, 95% confidence interval = 11.82–795.23, p < 0.001) was found to significantly increase the risk of receiving lifesaving intervention in the emergency department. Conclusion: Modified early warning score is found to be a good predictor for patients in need of lifesaving intervention in the emergency department.

scholarly journals Pregnancy physiology pattern prediction study (4P study): protocol of an observational cohort study collecting vital sign information to inform the development of an accurate centile-based obstetric early warning score

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016034 ◽  
Author(s):  
Fiona Kumar ◽  
Jude Kemp ◽  
Clare Edwards ◽  
Rebecca M Pullon ◽  
Lise Loerup ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Early Warning ◽  
Vital Signs ◽  
Observational Cohort Study ◽  
Mobile Internet ◽  
Early Warning Score ◽  
Evidence Based ◽  
Reference Ranges ◽  
Observational Cohort

IntroductionSuccessive confidential enquiries into maternal deaths in the UK have identified an urgent need to develop a national early warning score (EWS) specifically for pregnant or recently pregnant women to aid more timely recognition, referral and treatment of women who are developing life-threatening complications in pregnancy or the puerperium. Although many local EWS are in use in obstetrics, most have been developed heuristically. No current obstetric EWS has defined the thresholds at which an alert should be triggered using evidence-based normal ranges, nor do they reflect the changing physiology that occurs with gestation during pregnancy.Methods and analysisAn observational cohort study involving 1000 participants across three UK sites in Oxford, London and Newcastle. Pregnant women will be recruited at approximately 14 weeks’ gestation and have their vital signs (heart rate, blood pressure, respiratory rate, oxygen saturation and temperature) measured at 4 to 6-week intervals during pregnancy. Vital signs recorded during labour and delivery will be extracted from hospital records. After delivery, participants will measure and record their own vital signs daily for 2 weeks. During the antenatal and postnatal periods, vital signs will be recorded on an Android tablet computer through a custom software application and transferred via mobile internet connection to a secure database. The data collected will be used to define reference ranges of vital signs across normal pregnancy, labour and the immediate postnatal period. This will inform the design of an evidence-based obstetric EWS.Ethics and disseminationThe study has been approved by the NRES committee South East Coast–Brighton and Sussex (14/LO/1312) and is registered with the ISRCTN (10838017). All participants will provide written informed consent and can withdraw from the study at any point. All data collected will be managed anonymously. The findings will be disseminated in international peer-reviewed journals and through research conferences.

A single-centre observational cohort study of admission National Early Warning Score (NEWS)

Resuscitation ◽  
2015 ◽  
Vol 92 ◽  
pp. 89-93 ◽  
Author(s):  
Tom E.F. Abbott ◽  
Nidhi Vaid ◽  
Dorothy Ip ◽  
Nicholas Cron ◽  
Matt Wells ◽  
...  
Keyword(s):  
Cohort Study ◽  
Early Warning ◽  
Observational Cohort Study ◽  
Early Warning Score ◽  
Single Centre ◽  
Observational Cohort ◽  
National Early Warning Score

Pre-hospital use of early warning scores to improve detection and outcomes of sepsis

2021 ◽  
Vol 26 (3) ◽  
pp. 122-129
Author(s):  
Marina Maciver
Keyword(s):  
Patient Outcomes ◽  
Early Warning ◽  
Hospital Setting ◽  
High Sensitivity ◽  
Early Warning Score ◽  
Bibliographic Databases ◽  
Eligibility Criteria ◽  
Early Warning Scores ◽  
Life Threatening ◽  
Hospital Use

Sepsis is a life-threatening complication from infection. The early detection of sepsis pre-hospital is challenging. Early warning scores (EWS) are used in hospitals to identify deteriorating patients. The pre-hospital setting could be a beneficial extension to the use of EWSs. This review aimed to determine whether EWSs can identify patients with sepsis pre-hospital and predict patient outcomes. Bibliographic databases were searched for studies evaluating the pre-hospital use of EWSs. Studies were screened using eligibility criteria. Two studies examined the ability of pre-hospital EWSs to identify patients with critical illness, showing high sensitivity but low specificity. Four studies determined the prognostic effects of the National Early Warning Score (NEWS). The patients identified by NEWS to be high-risk were associated with worse outcomes. This systematic review demonstrated the successful use of EWSs in the pre-hospital setting, in identifying patients most at risk of deterioration and as a useful tool for decision-making.

scholarly journals Impact of Intensive Care Unit Readmissions on Patient Outcomes and the Evaluation of the National Early Warning Score to Prevent Readmissions: Literature Review

10.2196/13782 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e13782
Author(s):  
Heidi Mcneill ◽  
Saif Khairat
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Literature Review ◽  
Hospital Mortality ◽  
Patient Outcomes ◽  
Early Warning ◽  
Early Warning Score ◽  
Risk Stratification Tool ◽  
National Early Warning Score ◽  
The Impact

Background Intensive care unit (ICU) readmissions have been shown to increase a patient’s in-hospital mortality and length of stay (LOS). Despite this, no methods have been set in place to prevent readmissions from occurring. Objective The aim of this literature review was to evaluate the impact of ICU readmission on patient outcomes and to evaluate the effect of using a risk stratification tool, the National Early Warning Score (NEWS), on ICU readmissions. Methods A database search was performed on PubMed, Cumulative Index of Nursing and Allied Health Literature, Google Scholar, and ProQuest. In the initial search, 2028 articles were retrieved; after inclusion and exclusion criteria were applied, 12 articles were ultimately used in this literature review. Results This literature review found that patients readmitted to the ICU have an increased mortality rate and LOS at the hospital. The sample sizes in the reviewed studies ranged from 158 to 745,187 patients. Readmissions were most commonly associated with respiratory issues about 18% to 59% of the time. The NEWS has been shown to detect early clinical deterioration in a patient within 24 hours of transfer, with a 95% CI of 0.89 to 0.94 (P<.001), a sensitivity of 93.6% , and a specificity of 82.2%. Conclusions ICU readmissions are associated with worse patient outcomes, including hospital mortality and increased LOS. Without the use of an objective screening tool, the provider has been solely responsible for the decision of patient transfer. Assessment with the NEWS could be helpful in decreasing the frequency of inappropriate transfers and ultimately ICU readmission.

scholarly journals Impact of Intensive Care Unit Readmissions on Patient Outcomes and the Evaluation of the National Early Warning Score to Prevent Readmissions: Literature Review (Preprint)

2019 ◽  
Author(s):  
Heidi Mcneill ◽  
Saif Khairat
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Literature Review ◽  
Hospital Mortality ◽  
Patient Outcomes ◽  
Early Warning ◽  
Early Warning Score ◽  
Risk Stratification Tool ◽  
National Early Warning Score ◽  
The Impact

BACKGROUND Intensive care unit (ICU) readmissions have been shown to increase a patient’s in-hospital mortality and length of stay (LOS). Despite this, no methods have been set in place to prevent readmissions from occurring. OBJECTIVE The aim of this literature review was to evaluate the impact of ICU readmission on patient outcomes and to evaluate the effect of using a risk stratification tool, the National Early Warning Score (NEWS), on ICU readmissions. METHODS A database search was performed on PubMed, Cumulative Index of Nursing and Allied Health Literature, Google Scholar, and ProQuest. In the initial search, 2028 articles were retrieved; after inclusion and exclusion criteria were applied, 12 articles were ultimately used in this literature review. RESULTS This literature review found that patients readmitted to the ICU have an increased mortality rate and LOS at the hospital. The sample sizes in the reviewed studies ranged from 158 to 745,187 patients. Readmissions were most commonly associated with respiratory issues about 18% to 59% of the time. The NEWS has been shown to detect early clinical deterioration in a patient within 24 hours of transfer, with a 95% CI of 0.89 to 0.94 (<i>P</i>&lt;.001), a sensitivity of 93.6% , and a specificity of 82.2%. CONCLUSIONS ICU readmissions are associated with worse patient outcomes, including hospital mortality and increased LOS. Without the use of an objective screening tool, the provider has been solely responsible for the decision of patient transfer. Assessment with the NEWS could be helpful in decreasing the frequency of inappropriate transfers and ultimately ICU readmission.

Validity of Pediatric Early Warning Score in Predicting Unplanned Pediatric Intensive Care Unit Readmission

2021 ◽  
Author(s):  
Mojdeh Habibi Zoham ◽  
Masoud Mohammadpour ◽  
Bahareh Yaghmaie ◽  
Amere Hadizadeh ◽  
Zahra Eskandarizadeh ◽  
...  
Keyword(s):  
Intensive Care ◽  
Early Warning ◽  
Large Scale ◽  
Demographic Data ◽  
Pediatric Intensive Care ◽  
Early Warning Score ◽  
Unplanned Readmission ◽  
Predictive Tool ◽  
Point Increase ◽  
Study Interval

AbstractDespite the fact that unscheduled readmission to pediatric intensive care units (PICUs) has significant adverse consequences, there is a need for a predictive tool appropriate for use in the clinical setting. The aim of this study was to assess the ability of the modified Brighton pediatric early warning score (PEWS) to identify children at high risk for early unplanned readmission. In this retrospective cohort study, all patients aged 1 month to 18 years of age discharged from PICUs of two tertiary children's hospitals during the study interval were enrolled. Apart from demographic data, the association between PEWS and early readmission, defined as readmission within 48 hours of discharge, was analyzed by multivariable logistic regression. From 416 patients, 27 patients had early PICU readmission. Patients who experienced readmission were significantly younger than the controls. (≤12 months, 70.4 vs. 39.1%, p = 0.001) Patients who were admitted from the emergency room (66.7 and 33.3% for emergency department (ED) and floor, respectively, p = 0.012) had higher risk of early unplanned readmission. PEWS at discharge was significantly higher in patients who experienced readmission (3.07 vs. 0.8, p < 0.001). A cut-off PEWS of 2, with sensitivity 85.2% and specificity 78.1%, determined the risk of unplanned readmission. Each 1-point increase in the PEWS at discharge significantly increases the risk of readmission (odds ratio [OR] = 3.58, 95% confidence interval [CI]: [2.42–5.31], p < 0.001). PEWS can be utilized as a useful predictive tool regarding predicting unscheduled readmission in PICU. Further large-scale studies are needed to determine its benefits in clinical practice.

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