Effectiveness of Implementing Modified Early Warning System and Rapid Response Team for General Ward Inpatients
Abstract This retrospective study assessed the effectiveness and impact of implementing a Modified Early Warning System (MEWS) and Rapid Response Team (RRT) for inpatients admitted to the general ward (GW) of a medical center. This study included all inpatients who stayed in GWs from Jan. 2017 to Feb. 2022. We divided inpatients into $ GW_{non-MEWS} $ and $ GW_{MEWS} $ groups according to MEWS and RRT implementation in Aug. 2019. The primary outcome, unexpected deterioration, was defined by unplanned admission to intensive care units. We defined the detection performance and effectiveness of MEWS according to if a warning occurred within 24 h before the unplanned ICU admission. There were 129,039 inpatients included in this study, comprising 58,106 $ GW_{non-MEWS} $ and 71,023 $ GW_{MEWS} $. The numbers of inpatients who underwent an unplanned ICU admission in $ GW_{non-MEWS} $ and $ GW_{MEWS} $ were 488 (.84%) and 468 (.66%), respectively, indicating that the implementation significantly reduced unexpected deterioration (p < .0001). Besides, 1,551,525 times MEWS assessments were executed for the $ GW_{MEWS} $. The sensitivity, specificity, positive predicted value, and negative predicted value of the MEWS were 29.9%, 98.7%, 7.09%, and 99.76%, respectively. A total of 1,568 warning signs accurately occurred within the 24 h before an unplanned ICU admission. Among them, 428 (27.3%) met the criteria for automatically calling RRT, and 1,140 signs necessitated the nursing staff to decide if they needed to call RRT. Implementing MEWS and RRT increases nursing staff's monitoring and interventions and reduces unplanned ICU admissions..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
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| Enthalten in: |
Journal of medical systems - 48(2024), 1 vom: 26. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Liaw, Wen-Jinn [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| BKL: | |
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| Themen: |
Effectiveness |
| Anmerkungen: |
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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| doi: |
10.1007/s10916-024-02046-2 |
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| 520 | |a Abstract This retrospective study assessed the effectiveness and impact of implementing a Modified Early Warning System (MEWS) and Rapid Response Team (RRT) for inpatients admitted to the general ward (GW) of a medical center. This study included all inpatients who stayed in GWs from Jan. 2017 to Feb. 2022. We divided inpatients into $ GW_{non-MEWS} $ and $ GW_{MEWS} $ groups according to MEWS and RRT implementation in Aug. 2019. The primary outcome, unexpected deterioration, was defined by unplanned admission to intensive care units. We defined the detection performance and effectiveness of MEWS according to if a warning occurred within 24 h before the unplanned ICU admission. There were 129,039 inpatients included in this study, comprising 58,106 $ GW_{non-MEWS} $ and 71,023 $ GW_{MEWS} $. The numbers of inpatients who underwent an unplanned ICU admission in $ GW_{non-MEWS} $ and $ GW_{MEWS} $ were 488 (.84%) and 468 (.66%), respectively, indicating that the implementation significantly reduced unexpected deterioration (p < .0001). Besides, 1,551,525 times MEWS assessments were executed for the $ GW_{MEWS} $. The sensitivity, specificity, positive predicted value, and negative predicted value of the MEWS were 29.9%, 98.7%, 7.09%, and 99.76%, respectively. A total of 1,568 warning signs accurately occurred within the 24 h before an unplanned ICU admission. Among them, 428 (27.3%) met the criteria for automatically calling RRT, and 1,140 signs necessitated the nursing staff to decide if they needed to call RRT. Implementing MEWS and RRT increases nursing staff's monitoring and interventions and reduces unplanned ICU admissions. | ||
| 650 | 4 | |a Modified early warning system |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Rapid response team |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Unplanned admissions to the ICU |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a General ward |7 (dpeaa)DE-He213 | |
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| 700 | 1 | |a Tsai, Ming-Che |4 aut | |
| 700 | 1 | |a Lin, I-Chen |4 aut | |
| 700 | 1 | |a Liao, Yi-Han |4 aut | |
| 700 | 1 | |a Shen, Wei-Chih |0 (orcid)0009-0005-7193-389X |4 aut | |
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