Mews training ppt

1. Modified Early Warning
System (MEWS)
Quality Team-Ford Hospital & Research Centre -Patna
Ms Tissymol Thomas
Nursing Superintendent
Ford Hospital & Research Centre Patna

2. Modified Early Warning
System (MEWS)
• Description:
An evidenced-based organized screening tool with aggregated
scoring of “multiple” pre-determined indicators to assist in
early recognition and intervention of physiologic signs of
patient deterioration.
• Temperature
• Heart rate
• Blood Pressure
• Respiratory rate
• Level of consciousness
Quality Team-Ford Hospital & Research Centre -Patna

3. Everything Starts with a Question and Data
QUESTION: Can we detect and intervene to changes in
patient conditions before they reach a deteriorated state
requiring intervention from our Rapid Response and / or
Code Teams?
Spring Hill Data 2016 DATA:
• RRT = 115
• Code Blue = 58
Quality Team-Ford Hospital & Research Centre -Patna

4. Why?
To Eliminate Failures to Rescue
• Hospitalized patients often experience unrecognized physiological deterioration that
can lead to critical illness, transfer to the ICU, cardiac arrest, even death.
• Research indicates that a patient’s condition generally deteriorates 6-8 hours prior to a
code event.
 Schein et al. - 84% of patients had documented observations of
clinical deterioration or new complaints within 8 hours of
cardiopulmonary arrest with 70% experiencing either
respiratory or mental function alterations.)
 Hodgetts et al. – 17% of cardiac arrests occurred on patients
receiving care in an inappropriate area with 95% being
avoidable versus 60% avoidable rate when the patient was at the
right level of care.
Early Recognition and Intervention
=
Decreased Morbidity and Mortality
Quality Team-Ford Hospital & Research Centre -Patna

5. RRT versus MEWS
• RRT intervention is typically triggered by one aspect of a
patient's condition at a time.
• MEWS focuses on multiple areas
Quality Team-Ford Hospital & Research Centre -Patna

6. Scoring
Quality Team-Ford Hospital & Research Centre -Patna

7. Interventions
Quality Team-Ford Hospital & Research Centre -Patna

8. Patient Population
Adult Medical-Surgical and Progressive Care Patients
Ages 18 and greater
Screening will be performed upon admission, twice per shift,
and with changes in patient condition.
Adult patients in Medical-Surgical and Progressive Care
level of care will have routine Modified Early Warning System
(MEWS) screening and interventions based on changes in
temperature, heart rate, blood pressure, respiratory rate, and
level of consciousness.
Quality Team-Ford Hospital & Research Centre -Patna

9. Benefits to Nursing
• It is a nursing decision tool.
• MEWS is an aid to good clinical judgment, not a
substitute for critical thinking!
Quality Team-Ford Hospital & Research Centre -Patna

10. Clinical Scenario
• 46 Yr old F with Pneumonia
• On 2 liters NC oxygen Pulse ox 96% temp 99
• HR occurs and patient is now 88% on Pulse ox and looks
flushed Vital signs obtained
• Temp 101 Respirations 22 Heart Rate 111
• What is MEWS score?
• Would you call a RRT?
Quality Team-Ford Hospital & Research Centre -Patna

11. Thank You
Quality Team-Ford Hospital & Research Centre -Patna