The effectiveness of using the Modified Early Warning Signs in emergency patients at the Emergency Department, Selaphum Hospital

Abstract

Purpose: to study the effectiveness of using the Modified Early Warning Signs (MEWS)  in

patients at Emergency Department of Selaphum Hospital.

Design: A quasi-experimental research

Materials and Methods: The study participants included : 120 ER patients which were triaged as having Emergency Severity Index (ESI) of level 2 ( Emergent) and level 3 ( Urgent) between January 01- July 31, 2019  were enrolled into the study to use the Modified Early Warning Signs in guiding patient cares comparing with 120 ER patients in 2018 from Medical record review with standard patient cares. The main parameters of the study were 1) Unplanned ER revisit within 24 hrs after ER discharge, 2) Unplanned Referral within 24 hrs after hospital admission,  3) Unplanned ET intubation within 24 hrs after hospital admission.  The data were analyzed using Fisher's exact test.

Main findings: The patients which were the same triaged ESI levels belong to different MEWS groups.The accuracy of the triage was dependent to the experience and skill of the personnels doing the triage. There was no Unplanned ER Revisit with 24 hrs and no Unplanned Referral within 24 hrs. Only one case of Unplanned ET intubation within 24 hrs which was obviously statistically significant (p< 0.001).

Conclusion and recommendations: MEWS is an effective trigger tool helping nurses in assessing ER patients for decision making whether to continue emergency medical cares or provide further urgent cares.We suggest that MEWS be used in many other departments in the hospital.  The MEWS calculation program should be developed in conjunction with the patient recording program to reduce the recording time.