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Early Warning Systems – A study into the determination of accuracy and Protocol compliance

Early Warning Systems – A study into the determination of accuracy and Protocol compliance . A study by Pamela Munro, Consultant Nurse, Critical Care Amor Padala , Nurse Practitioner, Critical Care Whipps Cross University Hospital Presented by Jan McMeekin , Welch Allyn.

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Early Warning Systems – A study into the determination of accuracy and Protocol compliance

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  1. Early Warning Systems – A study into the determination of accuracy and Protocol compliance A study by Pamela Munro, Consultant Nurse, Critical Care Amor Padala, Nurse Practitioner, Critical Care Whipps Cross University Hospital Presented by Jan McMeekin, Welch Allyn

  2. Background to Study • Failure to rescue deteriorating patients is an area of significant unintended harm • ‘Track and Trigger’ systems introduced to help overcome this • Utilising an increase in clinical vigilance which includes increase in physiological monitoring • Accuracy of the data collected and adherence to the protocols is essential to the success of such a system

  3. Aim of Study • To assess accuracy of charting of observation round data and adherence to EWS protocols • Setting • Acute medical and surgical ward in DGH • Evaluation assessed vital signs recording in two ways • Standard manual recording • Automated collection

  4. Method • Collection of patient’s vital signs performed by healthcare worker (HW) • Data transferred manually to paper observation chart (normal practice) and EWS risk band calculated and recorded • Nurse Evaluator (NE) observed process and recorded vital signs data and EWS risk band as provided by HW onto Case Report From • Data also sent electronically into Connex System • Comparison of the two sets of data undertaken by statistician

  5. Results • 44 Healthcare Workers participated • Data collected • Systolic and diastolic Blood Pressure (SBP) (DBP) • Mean arterial pressure (MAP) • Pulse rate • Temperature • Oxygen saturation (SpO2) • 243 sets of data included in the Study

  6. Omission and Error Rates • Omission rate (%O) and Error Rate (%E) compared between the two collection methods

  7. Protocol for EWS Risk Band

  8. EWS Risk Band Analysis Adherence (%) to vital sign follow-up as determined by EWS Risk Band Assessment Only 60 (24.7%) cycles had the correct follow up procedure followed

  9. Conclusion and Discussion • Findings show significant error rates in documentation of vital signs in comparison to electronic collection and poor compliance to EWS protocols • Could be due to not only transcription errors but also chart design which hinders precise recording • Non-compliance with EWS protocol could be due to • Inaccurate manual recording of time • Vital signs not being recorded on the chart when collected • Prescribed time frames are inappropriate and/or impractical for clinical scenarios

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