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theses

Worldwide, hospitalized patients that deteriorate acutely may progress rapidly to cardiac arrest, and Modified Early Warning Score (MEWS) algorithms have been developed and implemented in healthcare institutions to early identify and early manage patient deterioration.
Purpose: To determine whether the introduction of a revised MEWS algorithm and an early recognition of patient deterioration education program would influence the number of rapid response calls, escalation of care situations, and number of code blue calls.
Methodology: Performance improvement project with pre-post analysis. Population: Retrospective chart review of adult patients ≥ 18 years of age hospitalized in two medical surgical units in a university hospital, who triggered a Rapid Response Team (RRT) call. Sample number: 111 charts were reviewed prior to the intervention, and 116 charts were reviewed after the intervention. Data collection: After implementation of the revised MEWS algorithm and education program, a retrospective chart review was performed pre-intervention and post-intervention to compare outcome measures (number of rapid response calls, number of code blue calls, and escalation of care situations), patient demographic data, whether the event occurred during the day or night shifts, and whether there was a RRT activation via the MEWS algorithm. Results: Findings showed no statistically significant difference in number of rapid response calls and code blue calls, between pre and post intervention periods, for first and second units. It showed a statistically significant difference in escalation of care situations in the first unit, but no statistically significant difference in escalation of care situations in the second unit between pre and post implementation periods.
Implications for Practice: Hospitalized patients that progress to cardiac arrest have low survival rates, and most of times are discharged from healthcare institutions with neurological or other physical disabilities. Although some findings were not statistically significant, the implementation of a revised MEWS algorithm and an education program generally improved escalation of care situations. There were improvements in early recognition of patient deterioration and patient outcomes, by preventing cardiac arrests from happening. This project assisted in early identifying clinical deterioration and managing hospitalized patients, resulting in a positive impact on patient safety and overall healthcare quality.

ETD_9539

DNP

Includes bibliographical references

doi:10.7282/t3-ydtq-a642

ETD doctoral

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