Mandatory early warning scoring—implementation evaluated with a mixed-methods approach

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• 作者：Gitte Bunkenborg ; ICRN ; PhD^a ; ^b ; ^{gitbunken@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; ^{gibu@regionsjaelland.dk" class="auth_mail" title="E-mail the corresponding author} ; Ingrid Poulsen ; RN ; PhD^c ; ^{ingrid.poulsen@regionh.dk" class="auth_mail" title="E-mail the corresponding author} ; Karin Samuelson ; RNANIC ; PhD^d ; ^{karin.samuelson@med.lu.se" class="auth_mail" title="E-mail the corresponding author} ; Steen Ladelund^e ; ^{steen.ladelund.01@regionh.dk" class="auth_mail" title="E-mail the corresponding author} ; Jonas Å ; keson ; MD ; PhD^b ; ^{jonas.akeson@med.lu.se" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Adherence ; Early Warning Score ; Implementation process ; Monitoring practice ; Vital parameters
• 刊名：Applied Nursing Research
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：29
• 期：Complete
• 页码：168-176
• 全文大小：1142 K

文摘

The aim of this study was to evaluate adherence to an intervention optimizing in-hospital monitoring practice, by introducing early warning scoring (EWS) of vital parameters.

Sec_2">Background

Interventions comprising EWS systems reduce in-hospital mortality, but evaluation of adherence to such interventions is required to correctly interpret interventional outcome.

Method

Adherence was evaluated with a mixed-methods approach. Quantitative data, obtained pre-interventionally (2009) and postinterventionally (2010 and 2011), were used to calculate and compare time intervals between scorings of vital parameters. Semi-structured interviews were used to evaluate the implementation process.

Results

We found significant reductions in time intervals between measurements of vital parameters in 2011 compared to 2009. Scorings of vital parameters were repeated within 8 hours in 71–77% of patients scoring total modified EWS levels of 0, 2 or 4. The theme Motivation by clinical relevance and meaningfulness was identified as crucial to the implementation process.

Conclusion

High adherence to an intervention may be strongly related to nurses' perceived clinical relevance of the intervention.