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Nation early warning sign

Angel Paternina-Caicedo, Jezid Miranda, Ghada Bourjeily, Andrew Levinson, Carmelo Dueñas, Camilo Bello Muñoz, José A Rojas-Suarez
BACKGROUND: Every day, about 830 women die worldwide from preventable causes related to pregnancy and childbirth. Obstetric early-warning scores have been proposed as a potential tool to reduce maternal morbidity and mortality, based upon the identification of predetermined abnormal values in the vital signs or laboratory parameters, to generate a rapid and effective medical response. Several early-warning scores have been developed for obstetrical patients, but the majority are the result of a clinical consensus rather than statistical analyses of clinical outcome measures (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
Philippe Cavailler, Arnaud Tarantola, Yee Sin Leo, Andrew A Lover, Anne Rachline, Moniboth Duch, Rekol Huy, Ai Li Quake, Yuvatha Kdan, Veasna Duong, Jeremy L Brett, Philippe Buchy
BACKGROUND: Dengue is endemic throughout Cambodia, a country faced with significant health and economic challenges. We undertook a clinical study at the National Paediatric Hospital in Phnom Penh to evaluate clinical diagnostic parameters for dengue and predictors of disease outcome. METHODS: Between September 2011 and January 2013, all consecutive inpatients aged between 1 and 15 years and presenting with suspected dengue were enrolled. They were clinically assessed using both the 1997 and 2009 WHO dengue classifications...
2016: BMC Infectious Diseases
(no author information available yet)
Early identification and management is vital in treating sepsis, and a new film, which aims to help clinicians spot and respond to warning signs of sepsis in children, has been launched by NHS Health Education England. The film, which features parents who lost their young daughter to undiagnosed sepsis, highlights the important signs clinicians should look for, and asks them to think 'could this be sepsis' when assessing children. It also highlights the wide range of learning resources available, including the new National Institute of Health and Care Excellence guidelines ( nice...
September 2016: Nursing Management (Harrow)
Gary B Smith, David R Prytherch, Stuart Jarvis, Caroline Kovacs, Paul Meredith, Paul E Schmidt, Jim Briggs
OBJECTIVE: To compare the ability of medical emergency team criteria and the National Early Warning Score to discriminate cardiac arrest, unanticipated ICU admission and death within 24 hours of a vital signs measurement, and to quantify the associated workload. DESIGN: Retrospective cohort study. SETTING: A large U.K. National Health Service District General Hospital. PATIENTS: Adults hospitalized from May 25, 2011, to December 31, 2013...
August 2, 2016: Critical Care Medicine
Jonathan Bannard-Smith, Geoffrey K Lighthall, Christian P Subbe, Lesley Durham, John Welch, Rinaldo Bellomo, Daryl A Jones
AIM: The study was developed to characterize short-term outcomes of deteriorating ward patients triggering a Rapid Response Team (RRT), and describe variability between hospitals or groups thereof. METHODS: We performed an international prospective study of Rapid Response Team (RRT) activity over a 7-day period in February 2014. Investigators at 51 acute hospitals across Australia, Denmark, the Netherlands, USA and United Kingdom collected data on all patients triggering RRT review concerning the nature, trigger and immediate outcome of RRT review...
October 2016: Resuscitation
Mohammed A Mohammed, Muhammad Faisal, Donald Richardson, Robin Howes, Kevin Beaston, Kevin Speed, John Wright
BACKGROUND: Patients admitted to hospitals over the weekend appear to have a higher risk of death compared to weekday admissions, but the reasons remain unclear. Unlike previous studies, we use a standardised mandated vital signs physiological based measure of sickness known as the National Early Warning Score (NEWS) to investigate this "weekend effect" for emergency admissions. AIM: To determine if weekend admissions are (1) sicker as measured by their index NEWS, (2) have an increased risk of death and (3) have less favourable monitoring of their vital signs compared with weekday admissions...
July 12, 2016: QJM: Monthly Journal of the Association of Physicians
Martin Spångfors, Lisa Arvidsson, Victoria Karlsson, Karin Samuelson
The National Early Warning Score - NEWS is a "track and trigger" scale designed to assess in-hospital patients' vital signs and detect clinical deterioration. In this study the NEWS was translated into Swedish and its association with the need of intensive care was investigated. A total of 868 patient charts, recorded by the medical emergency team at a university hospital, containing the parameters needed to calculate the NEWS were audited. The NEWS was translated into Swedish and tested for inter-rater reliability with a perfect agreement (weighted κ=1...
July 4, 2016: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Neelima Mishra, Bina Srivastava, Ram Suresh Bharti, Roma Rana, Kamlesh Kaitholia, Anupkumar R Anvikar, Manoj Kumar Das, Susanta K Ghosh, Rajendra M Bhatt, Prajesh K Tyagi, Vas Dev, Sobhan Phookan, Suman Lata Wattal, Gagan Singh Sonal, Akshay Chand Dhariwal, Neena Valecha
BACKGROUND & OBJECTIVES: To combat the problem of antimalarial drug resistance, monitoring the changes in drug efficacy over time through periodic surveillance is essential. Since 2009, systematic and continuous monitoring is being done through nationwide sentinel site system. Potential early warning signs like partner drug resistance markers were also monitored in the clinical samples from the study areas. METHODS: A total of 1864 patients with acute uncomplicated malaria were enrolled in therapeutic efficacy studies of artesunate plus sulphadoxine-pyrimethamine (AS+SP) for Plasmodium falciparum; those infected with P...
April 2016: Journal of Vector Borne Diseases
Bente Bilben, Linda Grandal, Signe Søvik
BACKGROUND: National Early Warning Score (NEWS) was designed to detect deteriorating patients in hospital wards, specifically those at increased risk of ICU admission, cardiac arrest, or death within 24 h. NEWS is not validated for use in Emergency Departments (ED), but emerging data suggest it may be useful. A criticism of NEWS is that patients with chronic poor oxygenation, e.g. severe chronic obstructive pulmonary disease (COPD), will have elevated NEWS also in the absence of acute deterioration, possibly reducing the predictive power of NEWS in this subgroup...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Yuan Liang Woon, Chee Peng Hor, Narwani Hussin, Ariza Zakaria, Pik Pin Goh, Wee Kooi Cheah
BACKGROUND: Dengue infection is the fastest spreading mosquito-borne viral disease, which affects people living in the tropical and subtropical countries. Malaysia had large dengue outbreaks in recent years. We aimed to study the demographics and clinical characteristics associated with dengue deaths in Malaysia. METHODS: We conducted a retrospective review on all dengue deaths that occurred nationwide between 1st January 2013 and 31st December 2014. Relevant data were extracted from mortality review reports and investigational forms...
May 2016: PLoS Neglected Tropical Diseases
Debra Van Kuiken, Myra Martz Huth
PROBLEM: Vital sign (VS) assessment and monitoring are often routinely scheduled whether they are needed or not. This practice led pediatric nurse leaders to voice concerns about the frequenty of VS at a National Summit for Pediatric and Adolescent Evidence-Based Practice. A search of databases yielded no direct evidence regarding frequency. However, we determined that before this question could be adequately addressed, we first needed answers to two other important questions concerning normative values for this population and what constitutes significant change in VS...
January 2016: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
Rebecca Kruisselbrink, Arthur Kwizera, Mark Crowther, Alison Fox-Robichaud, Timothy O'Shea, Jane Nakibuuka, Isaac Ssinabulya, Joan Nalyazi, Ashley Bonner, Tahira Devji, Jeffrey Wong, Deborah Cook
INTRODUCTION: Providing optimal critical care in developing countries is limited by lack of recognition of critical illness and lack of essential resources. The Modified Early Warning Score (MEWS), based on physiological parameters, is validated in adult medical and surgical patients as a predictor of mortality. The objective of this study performed in Uganda was to determine the prevalence of critical illness on the wards as defined by the MEWS, to evaluate the MEWS as a predictor of death, and to describe additional risk factors for mortality...
2016: PloS One
Duncan J Smith, Leanne M Aitken
AIMS AND OBJECTIVES: To investigate nurses' use of a single parameter track and trigger chart to inform implementation of the National Early Warning Scoring tool. To report the characteristics of patients with triggers, the frequency of different triggers, and the time taken to repeat observations. To explore the barriers and facilitators perceived by nursing staff relating to patient monitoring. BACKGROUND: Sub-optimal care of the deteriorating patient has been described for almost two decades...
January 2016: Journal of Clinical Nursing
Robert H Hollis, Laura A Graham, John P Lazenby, Daran M Brown, Benjamin B Taylor, Martin J Heslin, Loring W Rue, Mary T Hawn
OBJECTIVE: We examined whether an early warning score (EWS) could predict inpatient complications in surgical patients. BACKGROUND: Abnormal vitals often precede in-hospital mortality. The EWS calculated using vital signs has been developed to identify patients at risk for mortality. METHODS: Inpatient general surgery procedures with National Surgical Quality Improvement Project data from 2013 to 2014 were matched with enterprise data on vital signs and neurologic status to calculate the EWS for each postoperative vital set measured on the ward...
May 2016: Annals of Surgery
Barbara Nabayigga, John Kellett, Mikkel Brabrand, Martin Otyek Opio
BACKGROUND: The outcomes of patients with the same severity of illness in the developed and developing countries have not been compared. Illness severity can now be measured anywhere by the National Early Warning Score (NEWS). METHODS: An exploratory observational study that compared the 7, 30 and 60 days mortality of 195 Ugandan and 588 Danish acutely ill medical patients that had a NEWS >6 at the time of their admission to the hospital. The association of vital sign changes, alertness and mobility at admission on subsequent outcome was explored...
January 2016: European Journal of Internal Medicine
Regina W Urban, Mercy Mumba, Shirley D Martin, Janet Glowicz, Daisha J Cipher
This study addresses the development of a modified early warning system (MEWS) to predict hospital admissions from emergency departments (EDs) using the 2010 National Hospital Ambulatory Medical Care Survey (NHAMCS). A MEWS score was created for each patient in the NHAMCS data set using the vital signs recorded at admission. Multiple logistic regression analyses indicated that for every 1 unit increase in the MEWS score, patients were 33% more likely to be admitted to the hospital for further care even after controlling for demographics...
October 2015: Advanced Emergency Nursing Journal
Michael Xu, Benjamin Tam, Lehana Thabane, Alison Fox-Robichaud
INTRODUCTION: Multiple early warning scores (EWS) have been developed and implemented to reduce cardiac arrests on hospital wards. Case-control observational studies that generate an area under the receiver operator curve (AUROC) are the usual validation method, but investigators have also generated EWS with algorithms with no prior clinical knowledge. We present a protocol for the validation and comparison of our local Hamilton Early Warning Score (HEWS) with that generated using decision tree (DT) methods...
2015: BMJ Open
Mirza Mansoor Baig, Hamid GholamHosseini, Martin J Connolly
Health monitoring systems have rapidly evolved during the past two decades and have the potential to change the way healthcare is currently delivered. Smart monitoring systems automate patient monitoring tasks and thereby improve patient workflow management. Moreover, expert systems have the potential to assist clinicians and improve their performance by accurately executing repetitive tasks, to which humans are ill-suited. Clinicians working in hospital wards are responsible for conducting a multitude of tasks which require constant vigilance, and thus the need for a smart decision support system has arisen...
October 2015: Physiological Measurement
David Wong, Timothy Bonnici, Julia Knight, Lauren Morgan, Paul Coombes, Peter Watkinson
BACKGROUND: Recognising the limitations of a paper-based approach to documenting vital sign observations and responding to national clinical guidelines, we have explored the use of an electronic solution that could improve the quality and safety of patient care. We have developed a system for recording vital sign observations at the bedside, automatically calculating an Early Warning Score, and saving data such that it is accessible to all relevant clinicians within a hospital trust. We have studied current clinical practice of using paper observation charts, and attempted to streamline the process...
2015: BMC Medical Informatics and Decision Making
Patricia M Witcher, Melissa C Sisson
A better understanding of why women die during pregnancy, childbirth, or postpartum offers valuable insight into strategies aimed at preventing maternal deaths and arresting the progression in the severity of a complication. The rate of severe maternal morbidity and maternal mortality in the United States has been trending upward in recent years and has garnered national attention with concentration on bolstering reviews of maternal deaths and implementing patient safety initiatives. The obstetric nurse is in a unique position to improve maternal outcomes through the anticipation, recognition, and communication of the early warning signs of impending deterioration in maternal condition...
July 2015: Journal of Perinatal & Neonatal Nursing
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