Defense Date

7-18-2023

Graduation Date

Winter 12-15-2023

Submission Type

DNP Manuscript

Degree Name

Doctor of Nursing Practice (DNP)

Department

Doctor of Nursing Practice (DNP) Program

School

School of Nursing

Faculty Mentor

Catherine Johnson

Keywords

Patient deterioration, Early warning scores

Abstract

Despite considerable emphasis on patient safety and high-quality care in U.S. hospitals for the past two decades, significant challenges remain in the early detection and treatment of clinical deterioration in adult medical-surgical patients contributing to poor patient outcomes, increased resource utilization and increased costs. Modified early warning scoring (MEWS) systems have been used to identify patients at risk of deterioration. The Modified Early Warning System (MEWS) is effective in supporting the early detection and prevention of clinical deterioration of at-risk patients earlier in their hospitalization and potentially save lives (Institute for Healthcare Improvement, 2017). This project implemented MEWs on medical units in a community hospital over a threemonth period and found a significant improvement in the number of RRT activations and a reduction in Code Blue events. This study demonstrated an increase from 5.7 to 9.7 in RRT activations after MEWS implementation. A decrease in transfers to a higher level of care was also seen in the post-MEWS implementation phase compared to the pre-implementation transfer rate. It also demonstrated increased confidence in nursing staff in their ability to identify patient deterioration of patient on their medical units. Data demonstrated improved patient status, assessment, and RRT initiation, reducing patient transfers to ICU and improving patient outcomes. These safety initiatives can promote the highest level of quality for patient care. Keywords: MEWS, Patient deterioration, Rapid response teams, MEWS and the electronic health record, MEWS and mortality rate and clinical decision support.

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