Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country.

<h4>Objective</h4>The aim of the study was to develop and validate, by consensus, the construct and content of an observations chart for nurses incorporating a modified early warning scoring (MEWS) system for physiological parameters to be used for bedside monitoring on general wards in...

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Autores principales:	Una Kyriacos, Jennifer Jelsma, Michael James, Sue Jordan
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6f4da689194740a98794746bf6fb8da1
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spelling	oai:doaj.org-article:6f4da689194740a98794746bf6fb8da12021-11-18T08:35:50ZMonitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country.1932-620310.1371/journal.pone.0087073https://doaj.org/article/6f4da689194740a98794746bf6fb8da12014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24475226/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>The aim of the study was to develop and validate, by consensus, the construct and content of an observations chart for nurses incorporating a modified early warning scoring (MEWS) system for physiological parameters to be used for bedside monitoring on general wards in a public hospital in South Africa.<h4>Methods</h4>Delphi and modified face-to-face nominal group consensus methods were used to develop and validate a prototype observations chart that incorporated an existing UK MEWS. This informed the development of the Cape Town ward MEWS chart.<h4>Participants</h4>One specialist anaesthesiologist, one emergency medicine specialist, two critical care nurses and eight senior ward nurses with expertise in bedside monitoring (N = 12) were purposively sampled for consensus development of the MEWS. One general surgeon declined and one neurosurgeon replaced the emergency medicine specialist in the final round.<h4>Results</h4>Five consensus rounds achieved ≥70% agreement for cut points in five of seven physiological parameters respiratory and heart rates, systolic BP, temperature and urine output. For conscious level and oxygen saturation a relaxed rule of <70% agreement was applied. A reporting algorithm was established and incorporated in the MEWS chart representing decision rules determining the degree of urgency. Parameters and cut points differed from those in MEWS used in developed countries.<h4>Conclusions</h4>A MEWS for developing countries should record at least seven parameters. Experts from developing countries are best placed to stipulate cut points in physiological parameters. Further research is needed to explore the ability of the MEWS chart to identify physiological and clinical deterioration.Una KyriacosJennifer JelsmaMichael JamesSue JordanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 1, p e87073 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Una Kyriacos Jennifer Jelsma Michael James Sue Jordan Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country.
description	<h4>Objective</h4>The aim of the study was to develop and validate, by consensus, the construct and content of an observations chart for nurses incorporating a modified early warning scoring (MEWS) system for physiological parameters to be used for bedside monitoring on general wards in a public hospital in South Africa.<h4>Methods</h4>Delphi and modified face-to-face nominal group consensus methods were used to develop and validate a prototype observations chart that incorporated an existing UK MEWS. This informed the development of the Cape Town ward MEWS chart.<h4>Participants</h4>One specialist anaesthesiologist, one emergency medicine specialist, two critical care nurses and eight senior ward nurses with expertise in bedside monitoring (N = 12) were purposively sampled for consensus development of the MEWS. One general surgeon declined and one neurosurgeon replaced the emergency medicine specialist in the final round.<h4>Results</h4>Five consensus rounds achieved ≥70% agreement for cut points in five of seven physiological parameters respiratory and heart rates, systolic BP, temperature and urine output. For conscious level and oxygen saturation a relaxed rule of <70% agreement was applied. A reporting algorithm was established and incorporated in the MEWS chart representing decision rules determining the degree of urgency. Parameters and cut points differed from those in MEWS used in developed countries.<h4>Conclusions</h4>A MEWS for developing countries should record at least seven parameters. Experts from developing countries are best placed to stipulate cut points in physiological parameters. Further research is needed to explore the ability of the MEWS chart to identify physiological and clinical deterioration.
format	article
author	Una Kyriacos Jennifer Jelsma Michael James Sue Jordan
author_facet	Una Kyriacos Jennifer Jelsma Michael James Sue Jordan
author_sort	Una Kyriacos
title	Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country.
title_short	Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country.
title_full	Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country.
title_fullStr	Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country.
title_full_unstemmed	Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country.
title_sort	monitoring vital signs: development of a modified early warning scoring (mews) system for general wards in a developing country.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/6f4da689194740a98794746bf6fb8da1
work_keys_str_mv	AT unakyriacos monitoringvitalsignsdevelopmentofamodifiedearlywarningscoringmewssystemforgeneralwardsinadevelopingcountry AT jenniferjelsma monitoringvitalsignsdevelopmentofamodifiedearlywarningscoringmewssystemforgeneralwardsinadevelopingcountry AT michaeljames monitoringvitalsignsdevelopmentofamodifiedearlywarningscoringmewssystemforgeneralwardsinadevelopingcountry AT suejordan monitoringvitalsignsdevelopmentofamodifiedearlywarningscoringmewssystemforgeneralwardsinadevelopingcountry
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Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country.

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