Show simple item record

dc.contributor.authorFoley, Claire
dc.contributor.authorDowling, Maura
dc.date.accessioned2019-01-07T10:51:41Z
dc.date.issued2018-10-14
dc.identifier.citationFoley, Claire, & Dowling, Maura. How do nurses use the early warning score in their practice? A case study from an acute medical unit. Journal of Clinical Nursing, doi:10.1111/jocn.14713en_IE
dc.identifier.issn1365-2702
dc.identifier.urihttp://hdl.handle.net/10379/14758
dc.description.abstractAims and objectives This study aimed to describe how nurses use the early warning score (EWS) in an acute medical ward and their compliance with the EWS and explore their views and experiences of the EWS. Background early warning score systems have been implemented in response to upward trends in mortality rates. Nurses play a central role in the use of EWS systems. However, barriers to their use have been identified and include behavioural, cultural and organisational approaches to adherence. Improvement strategies including education and training and electronic devices have assisted in compliance with the system. Design A holistic single descriptive case study design was used. Methods Data triangulation was used including non‐participant observation, semi‐structured interviews with nurses and document analysis. Nurses were observed using EWS and were subsequently interviewed. Data analysis was guided by systematic text condensation (STC), an approach underpinned by Giorgi's phenomenological method, where meaning units and themes are identified. The study adhered to the consolidated criteria for reporting qualitative research (COREQ) guidelines. Results Three themes with associated meaning units were found. Protocol Adherence vs. Clinical Judgement addresses nurses’ knowledge, skill and experience and patient assessment. Parameter Adjustment and Escalation included parameters not being adjusted or reviewed, junior doctors not being authorised to set parameters and escalation. The final theme Culture highlighted a task‐driven approach and deficient communication processes. Conclusion This study highlights the need for ongoing training, behavioural change and a cultural shift by healthcare professionals and organisations to ensure adherence with EWS escalation protocols. Relevance to clinical practice Improvements in education and training into recognition, management and communication of a deteriorating patient are required. Also, a cultural shift is needed to improve compliance and adherence with EWS practice. The potential use of electronic data should be explored.en_IE
dc.formatapplication/pdfen_IE
dc.language.isoenen_IE
dc.publisherWileyen_IE
dc.relation.ispartofJournal Of Clinical Nursingen
dc.subjectAcute careen_IE
dc.subjectCase studyen_IE
dc.subjectDeteriorating patienten_IE
dc.subjectEarly warning scoreen_IE
dc.titleHow do nurses use the early warning score in their practice? A case study from an acute medical uniten_IE
dc.typeArticleen_IE
dc.date.updated2018-12-20T13:23:32Z
dc.identifier.doi10.1111/jocn.14713
dc.local.publishedsourcehttps://doi.org/10.1111/jocn.14713en_IE
dc.description.peer-reviewedpeer-reviewed
dc.description.embargo2019-10-14
dc.internal.rssid15314990
dc.local.contactMaura Dowling, School Of Nursing And Midwifery, Room 415 Aras Moyola, Newcastle Road, Galway. 3833 Email: maura.dowling@nuigalway.ie
dc.local.copyrightcheckedYes
dc.local.versionACCEPTED
nui.item.downloads0


Files in this item

Attribution-NonCommercial-NoDerivs 3.0 Ireland
This item is available under the Attribution-NonCommercial-NoDerivs 3.0 Ireland. No item may be reproduced for commercial purposes. Please refer to the publisher's URL where this is made available, or to notes contained in the item itself. Other terms may apply.

The following license files are associated with this item:

Thumbnail

This item appears in the following Collection(s)

Show simple item record