ArticleHeliyon2024
Variation in nurses' compliance with an Early Warning Score protocol: A retrospective cohort study.
Article in Heliyon, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Knowledge, attitude and practice of emergency care providers on obstetric haemorrhage in KwaZulu-Natal, South Africa: A cross-sectional study.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2025Article
- Carbon dioxide combining power as a predictor of unplanned ICU transfer in hospital wards: a retrospective cohort study.Frontiers in medicine · 2025Article
- Early detection of anastomotic leakage in colon cancer surgery: the role of early warning score and C-reactive protein.Annals of coloproctology · 2024Article
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Early Warning Score (EWS) protocols are based on intermittent vital sign measurements, and aim to detect clinical deterioration in a timely manner. Despite its predictive value, its effectiveness remains suboptimal. An important limitation appears to be poor compliance with the EWS protocol and its variation between general wards. The current research does not yet provide an understanding of EWS compliance and variation in different nursing wards. Aim: To explore the variation in nurses' compliance with the EWS protocol among patients with and without complications and between different nursing wards. Methods: In a retrospective single-center cohort study, all patient files from three nursing wards of a tertiary teaching hospital in the Netherlands were reviewed over a 1-month period. Compliance was divided into three categories:1) calculation accuracy, 2) monitoring frequency end 3) clinical response. Results: The cohort of 210 patients contained 5864 measurements, of which 4125 (70.6 %) included EWS. Significant differences in the measured vital signs within incomplete measurements were found among nursing wards. Compliance to monitoring frequency was higher within EWSs of 0-1 (78.4 %) than within EWSs of ≥2 (26.1 %). The proportion of correct follow-up was significantly higher in patients with complications, as was the correct clinical response to an EWS of ≥3 (84.8 % vs. 55.0; p = .011). Conclusion: Our results suggest suboptimal compliance with the EWS protocol, with large variations between patients with and without complications and between different general care wards. Nurses tended to be more compliant with the EWS protocol for patients with complications.
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