- Created on Wednesday, November 29 2006 05:00
Safety Counts! a newsletter highlighting safety at Hallmark Health System
Safety Counts March 2014 - Download entire PDF by clicking
Early warning system helps keep patients stable
Studying the past can inform the future for health care professionals. In 2012, a team of Hallmark Health System (HHS) nurse leaders delved into history to improve patient safety. They studied several very challenging cases and found some common issues related to nursing practice.
“These issues concerned nurses noticing, interpreting, and responding to the signs presented by each patient,” said HHS Chief Nursing Officer Nancy Gaden, RN. “These are subjective, based on a nurse’s experience and other factors. We wanted a more objective way to assess who is at risk and take action before the patient’s condition deteriorates.”
The team modified a tool found in the literature that became the Hallmark Health Early Warning System (HHEWS). It offers clear, objective criteria, based on a score, for when a nurse should
take action such as calling in the rapid response team (Critical
Assessment Team, or CAT).
Eight vital signs – including respiratory and heart rates, oxygen saturation level, white blood count and temperature – are scored. The total is the HHEWS score. Signs are rechecked at least every four hours. If the score is increasing, nurses can take quick action to escalate care as needed. HHEWS also can aid nurse-doctor discussions. HHS Chief
Medical Quality Officer Steven Sbardella, MD, said “the HHEWS tool can improve communication by creating an accepted ‘standard language’ and action plan for a patient. It’s not meant to
replace clinical expertise and interpretive skills, but the HHEWS focus on objective signs helps clinicians at all levels.”
During the last year, HHEWS was piloted on nursing floors at both hospitals. Of the more than 1,300 scoring sheets documented, 84 patients (6 percent) had scores high enough to trigger action such as transfer to a higher level of care.
Since then, the scoring system has become a part of the medical record for patients on medical-surgical floors. “We’ve seen an increase in the number of patients who are moved to a higher level of care before their condition worsens,” said Gaden. “This improves the likelihood for good outcomes for at-risk patients.”
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Tuesday, February 25 2014 14:04