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Forewarned is forearmed

If used properly, early warning systems have proved successful in helping nurses respond to deteriorating patients.

Outcomes for patients are often dependent on nurses’ ability to identify and respond to signs of increasing illness and initiate medical intervention.

In an attempt to improve these outcomes, hospitals have implemented a variety of systems including the rapid response system known as the Medical Emergency Team (MET) and the Modified Early Warning Score (MEWS).

But are these response systems being used effectively?

Not according to Andrea Reid, Rockhampton Hospital nurse educator and CQUniversity masters researcher.

“In my own experience working at a regional hospital where MEWS is in place, and anecdotal evidence, such as personal communication from MET nurses attending MET calls, I found that we really aren’t doing the best job we can at capturing people before they become critically unwell,” says Reid.

“The literature also suggests that despite the introduction of MEWS and MET we still aren’t saving as many people as we should.”

Concerned by this, Reid decided to look into what factors impact on nurses’ effective use of MEWS, which, she says, hasn’t been done before.

“The success of such early warning systems is pivotal on the early identification, assessment and management of the critically ill patient on the hospital ward,” she says.

“This research aims to explore acute care registered nurses’ understanding of the use of the MEWS. To do this I will be talking to registered nurses across the country – not just in Queensland.”

While only in its beginning stages, since starting her research Reid has identified the use of the early warning system suffers from the lack of standardisation.

“Elements of the MEWS can differ from facility to facility and state to state. Regional hospitals will be different to city hospitals. So while a nurse may have used MEWS in a Sydney hospital and therefore has an understanding of the system, if she relocates to Queensland the paperwork may be different,” says Reid.

“To me it makes sense to have a standard system, but I will wait and see what the research comes up with. I want to find out what problems nurses are experiencing and as a result what can be done to overcome them.

“It’s great that there is a system to guide nurses in making judgements relating to intervention, timing and communication, but it has to be effectively used if we are to see improved outcomes for patients.”

If you are a RN who currently uses the Modified Early Warning Score (MEWS) in your place of work then you are invited to participate in this research. Through participation in one on one interviews you can share your feelings and experiences about MEWS. All interviews will be confidential and take about an hour.

If you are interested in participating in this study please contact Andrea Reid via email: [email protected]

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