학술논문
Effectiveness of Implementing Modified Early Warning System and Rapid Response Team for General Ward Inpatients.
Document Type
Article
Author
Source
Subject
*PREDICTIVE tests
*VITAL signs
*PATIENTS
*T-test (Statistics)
*ELECTRONIC security systems
*EVALUATION of human services programs
*HOSPITAL nursing staff
*HOSPITAL admission & discharge
*RAPID response teams
*HOSPITAL patients
*RETROSPECTIVE studies
*DESCRIPTIVE statistics
*NURSING interventions
*EVALUATION of medical care
*CHI-squared test
*HOSPITAL mortality
*GLASGOW Coma Scale
*PRE-tests & post-tests
*ROOMS
*CLINICAL deterioration
*INTENSIVE care units
*EARLY warning score
*COMPARATIVE studies
*DATA analysis software
*ADVERSE health care events
*HOSPITAL wards
*SENSITIVITY & specificity (Statistics)
*EVALUATION
RESEARCH evaluation
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Language
ISSN
0148-5598
Abstract
This retrospective study assessed the effectiveness and impact of implementing a Modified Early Warning System (MEWS) and Rapid Response Team (RRT) for inpatients admitted to the general ward (GW) of a medical center. This study included all inpatients who stayed in GWs from Jan. 2017 to Feb. 2022. We divided inpatients into GWnon-MEWS and GWMEWS groups according to MEWS and RRT implementation in Aug. 2019. The primary outcome, unexpected deterioration, was defined by unplanned admission to intensive care units. We defined the detection performance and effectiveness of MEWS according to if a warning occurred within 24 h before the unplanned ICU admission. There were 129,039 inpatients included in this study, comprising 58,106 GWnon-MEWS and 71,023 GWMEWS. The numbers of inpatients who underwent an unplanned ICU admission in GWnon-MEWS and GWMEWS were 488 (.84%) and 468 (.66%), respectively, indicating that the implementation significantly reduced unexpected deterioration (p <.0001). Besides, 1,551,525 times MEWS assessments were executed for the GWMEWS. The sensitivity, specificity, positive predicted value, and negative predicted value of the MEWS were 29.9%, 98.7%, 7.09%, and 99.76%, respectively. A total of 1,568 warning signs accurately occurred within the 24 h before an unplanned ICU admission. Among them, 428 (27.3%) met the criteria for automatically calling RRT, and 1,140 signs necessitated the nursing staff to decide if they needed to call RRT. Implementing MEWS and RRT increases nursing staff's monitoring and interventions and reduces unplanned ICU admissions. [ABSTRACT FROM AUTHOR]