March 12, 2024
Registered Nurse Ashlee Lauren, left, a member of the Early Warning System working group at the Peter Lougheed Centre, chats on Unit 53 with Raman Janjua, Clinical Nurse Educator/RN and Marc Romero, RN. Photo by Leah Hennel.
Story by Kyle Lang | Photo by Leah Hennel
CALGARY — A valuable new tool for early detection of any deterioration in a patient’s condition — the Modified Early Warning System (MEWS) — has been added to Connect Care, the electronic clinical information system of Alberta Health Services.
MEWS and PEWS (a pediatric version for children) collates a patient’s vital signs with other clinical parameters to create an aggregate risk score for potential deterioration. As the risk score increases, it generates a Best Practice Advisory (BPA) or alert on the patient’s storyboard for nursing and respiratory therapy staff. The alert is also available on patient lists for charge nurses and physicians.
“We’ve been creating awareness for staff around the Early Warning System (EWS). Some important elements are the timely entry of vital signs which improves accuracy of the EWS and the need for staff to acknowledge the alert on the patient’s storyboard,” says Registered Nurse Ashlee Lauren, a member of the EWS working group at Peter Lougheed Centre (PLC), where she’s been visiting all the inpatient units to share with frontline staff how this tool supports their work and patient monitoring.
“Staff have been very receptive and acknowledge how the tool may assist them. I also received lots of feedback from frontline staff on how we can make the EWS even better.”
The EWS not only assists care providers for a specific patient assignment or care area, but also supports physicians who care for large groups of patients across many areas of a hospital.
"Viewing my own patient list before rounding — or my group's patients at the start of an on-call shift — the yellow ‘watcher’ and red ‘unstable’ icons in the MEWs column give me awareness of my patients who may be the most unwell,” says Dr. Echo Enns, a PLC hospitalist.
Many sites around the province have created additional escalation-of-care guidelines, or recommended actions to be taken, should an EWS risk score increase. Common themes within these guidelines include increasing the level of monitoring for the patient as well as raising awareness among members of a care team.
Another benefit of Connect Care is how it allows staff to view data directly from the system and monitor progress through the EWS Surveillance dashboard.
The dashboard delivers information around EWS score distribution, vital signs completeness and Best Practice Advisory acknowledgement rates, often an indicator of how staff are interacting with the EWS system. The PLC — which adopted Connect Care early on during Wave 4 — has seen a steady increase in its BPA acknowledgement rates.
“Our care environments can be very busy with many competing needs of our staff,” says Emma Folz, executive director and site lead for the PLC MEWS.
“The MEWS tool will never replace the essential critical thinking of our clinical teams, but rather provide awareness of the potential need to focus in on a patient who’s showing early signs of deterioration.”
