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Early warning score

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https://www.readbyqxmd.com/read/28715794/an-introduction-to-the-emergency-department-adult-clinical-escalation-protocol-ed-ace
#1
Eoin Coughlan, Una Geary, Abel Wakai, Ronan O'Sullivan, John Browne, Eilish McAuliffe, Marie Ward, Fiona McDaid, Conor Deasy
PURPOSE OF THE STUDY: This study demonstrates how a participatory action research approach was used to address the challenge of the early and effective detection of the deteriorating patient in the ED setting. The approach enabled a systematic approach to patient monitoring and escalation of care to be developed to address the wide-ranging spectrum of undifferentiated presentations and the phases of ED care from triage to patient admission. This paper presents a longitudinal patient monitoring system, which aims to provide monitoring and escalation of care, where necessary, of adult patients from triage to admission to hospital in a manner that is feasible in the unique ED environment...
November 14, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28699997/accuracy-of-a-pediatric-early-warning-score-in-the-recognition-of-clinical-deterioration
#2
Juliana de Oliveira Freitas Miranda, Climene Laura de Camargo, Carlito Lopes Nascimento, Daniel Sales Portela, Alan Monaghan
Objective: to evaluate the accuracy of the version of the Brighton Pediatric Early Warning Score translated and adapted for the Brazilian context, in the recognition of clinical deterioration. Method: a diagnostic test study to measure the accuracy of the Brighton Pediatric Early Warning Score for the Brazilian context, in relation to a reference standard. The sample consisted of 271 children, aged 0 to 10 years, blindly evaluated by a nurse and a physician, specialists in pediatrics, with interval of 5 to 10 minutes between the evaluations, for the application of the Brighton Pediatric Early Warning Score for the Brazilian context and of the reference standard...
July 10, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28691745/prospective-evaluation-of-the-whitt-neonatal-trigger-score-in-an-at-risk-neonatal-population
#3
Anna Robinson, Lucinda C Winckworth, Georgios Eleftheriou, Rebecca Hewitson, Harriet Holme
AIM: The aim of this study was to prospectively evaluate the Whitt Neonatal Trigger Score (W-NTS), determining optimum threshold scores for consideration of medical intervention and intensive care unit admission. METHODS: All neonates on the postnatal ward (PNW) with a set of pre-defined risk factors were scored on the W-NTS. Neonates were divided into three groups: 'unwell' admitted to neonatal intensive care unit (NICU); 'well', who remained on the PNW receiving standard care; and 'intervention', who received antibiotics but did not require admission to NICU...
July 10, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28686949/early-maladaptive-schemas-and-suicidal-risk-in-an-iranian-sample-of-patients-with-obsessive-compulsive-disorder
#4
Vahid Khosravani, Farangis Sharifi Bastan, Mehdi Samimi Ardestani, Razieh Jamaati Ardakani
There are few studies on suicidal risk and its related factors in patients diagnosed with obsessive-compulsive disorder (OCD). This study investigated the associations of early maladaptive schemas, OC symptom dimensions, OCD severity, depression and anxiety with suicidality (i.e., suicidal ideation and suicide attempts) in OCD patients. Sixty OCD outpatients completed the Scale for Suicide Ideation (SSI), the Young Schema Questionnaire-Short Form (YSQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21)...
June 27, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28679490/continuous-monitoring-of-vital-signs-using-wearable-devices-on-the-general-ward-pilot-study
#5
Mariska Weenk, Harry van Goor, Bas Frietman, Lucien Jlpg Engelen, Cornelis Jhm van Laarhoven, Jan Smit, Sebastian Jh Bredie, Tom H van de Belt
BACKGROUND: Measurement of vital signs in hospitalized patients is necessary to assess the clinical situation of the patient. Early warning scores (EWS), such as the modified early warning score (MEWS), are generally calculated 3 times a day, but these may not capture early deterioration. A delay in diagnosing deterioration is associated with increased mortality. Continuous monitoring with wearable devices might detect clinical deterioration at an earlier stage, which allows clinicians to take corrective actions...
July 5, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28670880/awareness-about-breast-cancer-and-its-screening-among-rural-egyptian-women-minia-district-a-population-based-study
#6
Ebtesam Esmail Hassan, Amany Edward Seedhom, Eman Mohamed Mahfouz
Background: Recent global cancer statistics indicate rising global incidence of breast cancer and the increase is occurring at a faster rate in developing countries. Training women how to carry out breast self-examination (BSE) can help them to be alert to any abnormalities in their breasts to speedily seek medical consultation. Health behavior may be influenced by level of awareness about breast cancer. Methods: A cross-sectional community- based study aimed to assess the level of knowledge about breast cancer risk factors, early warning signs, screening approaches and related predictors...
June 25, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28646727/pulmonary-embolism-prognostic-factors-and-length-of-hospital-stay-a-cohort-study
#7
Marco Paolo Donadini, Francesco Dentali, Marco Castellaneta, Paola Gnerre, Micaela La Regina, Luca Masotti, Filippo Pieralli, Fulvio Pomero, Roberta Re, Luigina Guasti, Walter Ageno, Alessandro Squizzato
INTRODUCTION: Patients with pulmonary embolism (PE) are commonly admitted to hospital for their initial treatment. We aimed to assess the association of length of hospital stay with commonly available clinical variables and their combinations. METHODS: A retrospective multicenter cohort study was conducted on consecutive PE patients admitted to eight Italian centers. Logistic regression analysis was performed to evaluate the association between the length of hospital stay and the Pulmonary Embolism Severity Index (PESI) parameters, National Early Warning Score (NEWS) and other possible determinants...
June 8, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28638239/using-transfer-learning-for-improved-mortality-prediction-in-a-data-scarce-hospital-setting
#8
Thomas Desautels, Jacob Calvert, Jana Hoffman, Qingqing Mao, Melissa Jay, Grant Fletcher, Chris Barton, Uli Chettipally, Yaniv Kerem, Ritankar Das
Algorithm-based clinical decision support (CDS) systems associate patient-derived health data with outcomes of interest, such as in-hospital mortality. However, the quality of such associations often depends on the availability of site-specific training data. Without sufficient quantities of data, the underlying statistical apparatus cannot differentiate useful patterns from noise and, as a result, may underperform. This initial training data burden limits the widespread, out-of-the-box, use of machine learning-based risk scoring systems...
2017: Biomedical Informatics Insights
https://www.readbyqxmd.com/read/28635463/an-overview-of-the-evidence-based-practice-process-for-novice-researchers
#9
Emma Rowles, Amanda McNaughton
This article explores how nurses can use evidence-based practice to critique and evaluate the rationale and evidence for specific nursing procedures or practices. Through the development of a focused research question and search strategy, nurses can select and critique relevant research articles to answer the research question, which can support the provision of optimal practice and high-quality care. This article demonstrates the process of evidence-based practice, with the aim of increasing novice researchers' confidence in applying this process in practice...
June 21, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28628498/earlier-physical-therapy-input-is-associated-with-a-reduced-length-of-hospital-stay-and-reduced-care-needs-on-discharge-in-frail-older-inpatients-an-observational-study
#10
Peter J Hartley, Victoria L Keevil, Ledia Alushi, Rebecca L Charles, Eimear B Conroy, Patricia M Costello, Becki Dixon, Aida M Dolinska-Grzybek, Diana Vajda, Roman Romero-Ortuno
BACKGROUND AND PURPOSE: Pressures on hospital bed occupancy in the English National Health Service have focused attention on enhanced service delivery models and methods by which physical therapists might contribute to effective cost savings, while retaining a patient-centered approach. Earlier access to physical therapy may lead to better outcomes in frail older inpatients, but this has not been well studied in acute National Health Service hospitals. Our aim was to retrospectively study the associations between early physical therapy input and length of hospital stay (LOS), functional outcomes, and care needs on discharge...
June 16, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28608136/early-impairment-of-intracranial-conduction-time-predicts-mortality-in-deeply-sedated-critically-ill-patients-a-prospective-observational-pilot-study
#11
Eric Azabou, Benjamin Rohaut, Nicholas Heming, Eric Magalhaes, Régine Morizot-Koutlidis, Stanislas Kandelman, Jeremy Allary, Guy Moneger, Andrea Polito, Virginie Maxime, Djillali Annane, Frederic Lofaso, Fabrice Chrétien, Jean Mantz, Raphael Porcher, Tarek Sharshar
BACKGROUND: Somatosensory (SSEP) and brainstem auditory (BAEP) evoked potentials are neurophysiological tools which, respectively, explore the intracranial conduction time (ICCT) and the intrapontine conduction time (IPCT). The prognostic values of prolonged cerebral conduction times in deeply sedated patients have never been assessed. Sedated patients are at risk of developing new neurological complications, undetected. In this prospective observational bi-center pilot study, we investigated whether early impairment of SSEP's ICCT and/or BAEP's IPCT could predict in-ICU mortality or altered mental status (AMS), in deeply sedated critically ill patients...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28595614/a-multicentre-randomised-intervention-study-of-the-paediatric-early-warning-score-study-protocol-for-a-randomised-controlled-trial
#12
Claus Sixtus Jensen, Hanne Aagaard, Hanne Vebert Olesen, Hans Kirkegaard
BACKGROUND: Patients' evolving critical illness can be predicted and prevented. However, failure to identify the signs of critical illness and subsequent lack of appropriate action for patients developing acute and critical illness remain a problem. Challenges in assessing whether a child is critically ill may be due to children's often uncharacteristic symptoms of serious illness. Children may seem relatively unaffected until shortly before circulatory and respiratory failure and cardiac arrest...
June 8, 2017: Trials
https://www.readbyqxmd.com/read/28592360/clinical-study-of-a-new-modified-early-warning-system-scoring-system-some-lingering-doubts
#13
Xianshi Zhou, Ye Ye, Guanghua Tang
No abstract text is available yet for this article.
June 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28589426/clinical-condition-and-comorbidity-as-determinants-for-blood-culture-positivity-in-patients-with-skin-and-soft-tissue-infections
#14
F V van Daalen, M C Kallen, C M A van den Bosch, M E J L Hulscher, S E Geerlings, J M Prins
The utility of performing blood cultures in patients with a suspected skin infection is debated. We investigated the association between blood culture positivity rates and patients' clinical condition, including acute disease severity and comorbidity. We performed a retrospective study, including patients with cellulitis and wound infection who had been enrolled in three Dutch multicenter studies between 2011 and 2015. Patients' acute clinical condition was assessed using the Modified Early Warning Score (MEWS; severe: MEWS ≥2) and comorbidity with the Charlson Comorbidity Index (CCI; severe: CCI ≥2)...
June 7, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28588013/building-a-visual-aid-for-a-triage-tool-in-a-developing-health-service
#15
Mir Saaduddin Ahmad, Darryl R Wood
Resources in the modern day emergency department are often stretched, and this holds true more so in developing services. With limited manpower, it is essential that efficient tools are created so that processes can be run safely. Here we pilot the use of a vital signs matrix in a medical camp in Dhaka to screen patients at triage. We further modified this matrix to include the National Early Warning Score as our recording of the NEWS have remained poor in triage. A trial and validation study for the use of this matrix in an NHS setting is currently underway...
June 6, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28580508/economics-of-early-warning-scores-for-identifying-clinical-deterioration-a-systematic-review
#16
A Murphy, J Cronin, R Whelan, F J Drummond, E Savage, J Hegarty
AIM: In 2013, a National Early Warning System (EWS) was implemented in Ireland. Whilst evidence exists to support the clinical effectiveness of EWS in the acute health care setting, there is a paucity of information on their cost and cost effectiveness. The objective of this systematic literature review was to critically evaluate the economic literature on the use of EWS in adult patients in acute health care settings for the timely detection of physiological deterioration. METHODS: A systematic literature review was conducted to accumulate the economic evidence on the use of EWS in adult patients in acute health care settings...
June 3, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28578860/assessment-on-the-leakage-hazard-of-landfill-leachate-using-three-dimensional-excitation-emission-fluorescence-and-parallel-factor-analysis-method
#17
Hongwei Pan, Hongjun Lei, Xin Liu, Huaibin Wei, Shufang Liu
A large number of simple and informal landfills exist in developing countries, which pose as tremendous soil and groundwater pollution threats. Early warning and monitoring of landfill leachate pollution status is of great importance. However, there is a shortage of affordable and effective tools and methods. In this study, a soil column experiment was performed to simulate the pollution status of leachate using three-dimensional excitation-emission fluorescence (3D-EEMF) and parallel factor analysis (PARAFAC) models...
June 1, 2017: Waste Management
https://www.readbyqxmd.com/read/28576794/does-having-a-doctor-present-on-every-medical-ward-on-a-bank-holiday-improve-escalation-and-timeliness-of-review-of-a-patient-with-a-high-national-early-warning-score-news
#18
Olivia Dow, Tahir Akbar
No abstract text is available yet for this article.
June 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28570115/managing-sepsis-effectively-with-national-early-warning-scores-and-screening-tools
#19
Joanne Jones
No abstract text is available yet for this article.
June 2, 2017: British Journal of Community Nursing
https://www.readbyqxmd.com/read/28566256/validating-the-performance-of-the-modified-early-obstetric-warning-system-multivariable-model-to-predict-maternal-intensive-care-unit-admission
#20
Helen M Ryan, Meghan A Jones, Beth A Payne, Sumedha Sharma, Anna M Hutfield, Tang Lee, U Vivian Ukah, Keith R Walley, Laura A Magee, Peter von Dadelszen
OBJECTIVES: To evaluate the performance of the Modified Early Obstetric Warning System (MEOWS) to predict maternal ICU admission in an obstetric population. DESIGN: Case-control study. SETTING: Two maternity units in Vancouver, Canada, one with ICU facilities, between January 1, 2000, and December 31, 2011. PATIENTS: Pregnant or recently delivered (≤6 weeks) women admitted to the hospital for >24 hours. Three control patients were randomly selected per case and matched for year of admission...
May 26, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
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