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Implementation of an Electronic National Early Warning System to Decrease Clinical Deterioration in Hospitalized Patients at a Tertiary Medical Center
- Source :
- International Journal of Environmental Research and Public Health, Vol 18, Iss 4550, p 4550 (2021), International Journal of Environmental Research and Public Health, Volume 18, Issue 9
- Publication Year :
- 2021
- Publisher :
- MDPI AG, 2021.
-
Abstract
- The National Early Warning Score (NEWS) is an early warning system that predicts clinical deterioration. The impact of the NEWS on the outcome of healthcare remains controversial. This study was conducted to evaluate the effectiveness of implementing an electronic version of the NEWS (E-NEWS), to reduce unexpected clinical deterioration. We developed the E-NEWS as a part of the Health Information System (HIS) and Nurse Information System (NIS). All adult patients admitted to general wards were enrolled into the current study. The “adverse event” (AE) group consisted of patients who received cardiopulmonary resuscitation (CPR), were transferred to an intensive care unit (ICU) due to unexpected deterioration, or died. Patients without AE were allocated to the control group. The development of the E-NEWS was separated into a baseline (October 2018 to February 2019), implementation (March to August 2019), and intensive period (September. to December 2019). A total of 39,161 patients with 73,674 hospitalization courses were collected. The percentage of overall AEs was 6.06%. Implementation of E-NEWS was associated with a significant decrease in the percentage of AEs from 6.06% to 5.51% (p = 0.001). CPRs at wards were significantly reduced (0.52% to 0.34%, p = 0.012). The number of patients transferred to the ICU also decreased significantly (3.63% to 3.49%, p = 0.035). Using multivariate analysis, the intensive period was associated with reducing AEs (p = 0.019). In conclusion, we constructed an E-NEWS system, updating the NEWS every hour automatically. Implementing the E-NEWS was associated with a reduction in AEs, especially CPRs at wards and transfers to ICU from ordinary wards.
- Subjects :
- Adult
medicine.medical_specialty
Multivariate analysis
Hospitalized patients
early warning score
Health, Toxicology and Mutagenesis
medicine.medical_treatment
education
030204 cardiovascular system & hematology
cardiopulmonary resuscitation
Article
law.invention
03 medical and health sciences
0302 clinical medicine
law
Health care
medicine
Humans
030212 general & internal medicine
Cardiopulmonary resuscitation
Hospital Mortality
Adverse effect
health care economics and organizations
business.industry
Public Health, Environmental and Occupational Health
Early warning score
health information system
Intensive care unit
Hospitals
Hospitalization
Intensive Care Units
Emergency medicine
Early warning system
Medicine
Electronics
clinical deterioration
business
Subjects
Details
- Language :
- English
- ISSN :
- 16617827 and 16604601
- Volume :
- 18
- Issue :
- 4550
- Database :
- OpenAIRE
- Journal :
- International Journal of Environmental Research and Public Health
- Accession number :
- edsair.doi.dedup.....19f627b1e79660f77a076089924e482b