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Barriers and facilitating factors related to use of early warning score among acute care nurses: a qualitative study

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@article{47aaee5b3bd64ba2a580a2e91435374a,
title = "Barriers and facilitating factors related to use of early warning score among acute care nurses: a qualitative study",
abstract = "BACKGROUND: The early warning score (EWS) was developed to identify deteriorating patients early. It is a track-and-trigger system based on vital signs designed to direct appropriate clinical responses based on the seriousness and nature of the underlying condition. Despite its wide dissemination, serious adverse events still occur, often due to failure among staff on general wards to follow the EWS protocol. The purpose of the study was to determine barriers and facilitating factors related to three aspects of the EWS protocol: 1) adherence to monitoring frequency, 2) call for junior doctors to patients with an elevated EWS, and 3) call for the medical emergency team.METHODS: Focus groups were conducted with nurses from medical and surgical acute care wards, and content analysis was used to identify barriers and facilitating factors in relation to the research questions.RESULTS: Adherence to monitoring frequency would frequently be set aside during busy periods for other tasks. Collaboration and communication with doctors about medical patients with elevated EWS was considered to be unrealistic due to the high number of patients with these scores. Collaboration with the medical emergency team was problematic, since many nurses found the team to have negative attitudes.CONCLUSION: EWS reduces complex clinical conditions to a single number, with the inherent risk to overlook clinical cues and subtle changes in patients' condition. The study showed that identifying and treating deteriorating patients is a collaborative task that requires diverse technical and non-technical skills for staff to perform optimally.",
keywords = "Journal Article",
author = "Petersen, {John Asger} and Rasmussen, {Lars S} and Susan Rydahl-Hansen",
year = "2017",
month = "12",
day = "1",
doi = "10.1186/s12873-017-0147-0",
language = "English",
volume = "17",
pages = "36",
journal = "BMC Emergency Medicine",
issn = "1471-227X",
publisher = "BioMed Central Ltd",
number = "1",

}

RIS

TY - JOUR

T1 - Barriers and facilitating factors related to use of early warning score among acute care nurses

T2 - a qualitative study

AU - Petersen, John Asger

AU - Rasmussen, Lars S

AU - Rydahl-Hansen, Susan

PY - 2017/12/1

Y1 - 2017/12/1

N2 - BACKGROUND: The early warning score (EWS) was developed to identify deteriorating patients early. It is a track-and-trigger system based on vital signs designed to direct appropriate clinical responses based on the seriousness and nature of the underlying condition. Despite its wide dissemination, serious adverse events still occur, often due to failure among staff on general wards to follow the EWS protocol. The purpose of the study was to determine barriers and facilitating factors related to three aspects of the EWS protocol: 1) adherence to monitoring frequency, 2) call for junior doctors to patients with an elevated EWS, and 3) call for the medical emergency team.METHODS: Focus groups were conducted with nurses from medical and surgical acute care wards, and content analysis was used to identify barriers and facilitating factors in relation to the research questions.RESULTS: Adherence to monitoring frequency would frequently be set aside during busy periods for other tasks. Collaboration and communication with doctors about medical patients with elevated EWS was considered to be unrealistic due to the high number of patients with these scores. Collaboration with the medical emergency team was problematic, since many nurses found the team to have negative attitudes.CONCLUSION: EWS reduces complex clinical conditions to a single number, with the inherent risk to overlook clinical cues and subtle changes in patients' condition. The study showed that identifying and treating deteriorating patients is a collaborative task that requires diverse technical and non-technical skills for staff to perform optimally.

AB - BACKGROUND: The early warning score (EWS) was developed to identify deteriorating patients early. It is a track-and-trigger system based on vital signs designed to direct appropriate clinical responses based on the seriousness and nature of the underlying condition. Despite its wide dissemination, serious adverse events still occur, often due to failure among staff on general wards to follow the EWS protocol. The purpose of the study was to determine barriers and facilitating factors related to three aspects of the EWS protocol: 1) adherence to monitoring frequency, 2) call for junior doctors to patients with an elevated EWS, and 3) call for the medical emergency team.METHODS: Focus groups were conducted with nurses from medical and surgical acute care wards, and content analysis was used to identify barriers and facilitating factors in relation to the research questions.RESULTS: Adherence to monitoring frequency would frequently be set aside during busy periods for other tasks. Collaboration and communication with doctors about medical patients with elevated EWS was considered to be unrealistic due to the high number of patients with these scores. Collaboration with the medical emergency team was problematic, since many nurses found the team to have negative attitudes.CONCLUSION: EWS reduces complex clinical conditions to a single number, with the inherent risk to overlook clinical cues and subtle changes in patients' condition. The study showed that identifying and treating deteriorating patients is a collaborative task that requires diverse technical and non-technical skills for staff to perform optimally.

KW - Journal Article

U2 - 10.1186/s12873-017-0147-0

DO - 10.1186/s12873-017-0147-0

M3 - Journal article

VL - 17

SP - 36

JO - BMC Emergency Medicine

JF - BMC Emergency Medicine

SN - 1471-227X

IS - 1

ER -

ID: 52089519