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Jeroen Ludikhuize Marjon Borgert Jan Binnekade Christian Subbe Dave Dongelmans Astrid Goossens 《Resuscitation》2014
Purpose
To study the effect of protocolized measurement (three times daily) of the Modified Early Warning Score (MEWS) versus measurement on indication on the degree of implementation of the Rapid Response System (RRS).Methods
A quasi-experimental study was conducted in a University Hospital in Amsterdam between September and November 2011. Patients who were admitted for at least one overnight stay were included. Wards were randomized to measure the MEWS three times daily (“protocolized”) versus measuring the MEWS “when clinically indicated” in the control group. At the end of each month, for an entire seven-day week, all vital signs recorded for patients were registered. The outcomes were categorized into process measures including the degree of implementation and compliance to set monitoring standards and secondly, outcomes such as the degree of delay in physician notification and Rapid Response Team (RRT) activation in patients with raised MEWS (MEWS ≥ 3).Results
MEWS calculations from vital signs occurred in 70% (2513/3585) on the protocolized wards versus 2% (65/3013) in the control group. Compliance with the protocolized regime was presents in 68% (819/1205), compliance in the control group was present in 4% (47/1232) of the measurements. There were 90 calls to primary physicians on the protocolized and 9 calls on the control wards. Additionally on protocolized wards, there were twice as much RRT calls per admission.Conclusions
Vital signs and MEWS determination three times daily, results in better detection of physiological abnormalities and more reliable activations of the RRT. 相似文献2.
目的探讨改良早期预警评分(modified early warning score,MEWS)在急诊呼吸系统潜在危重症患者预后中的应用价值。方法对湖北医药学院附属人民医院急诊科2014年5-10月收治的566例呼吸系统患者进行MEWS评分,追踪患者预后,分析MEWS评分与患者预后的相关性;比较存活、死亡患者的MEWS分值和MEWS评分对患者预后鉴别的ROC曲线。结果死亡组MEWS评分高于存活组,差异有统计学意义(t=-10.02,P0.05);MEWS分值与患者预后呈正相关(r=0.63,P0.05)。以死亡为预测指标时,MEWS评分的最佳截断点为3.5分、灵敏度66%、特异度74%、阳性预测值62%、阴性预测值93%、ROC曲线下面积AZ=0.743(95%CI:0.663 0.823)。结论 MEWS评分对急诊呼吸系统潜在危重症患者预后预测有中等的分辨能力,其评分方法简单、实用,可以在急诊呼吸系统患者中使用。 相似文献
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