Implementing a modified early warning system for critically ill patients in an acute private hospital

Abstract

* This paper describes a project to implement an early warning scoring system within an Australian private hospital.* Sub-optimal care of critically ill patients on general wards has been described in the literature. Early warning systems have proved successful in supporting ward nurses to respond to deteriorating patients. They have been used mainly in the UK and in the public health system.* We believed that a modified early warning system could be adapted to the specific needs of an acute private hospital and would also have a positive effect on the outcomes of critically ill ward patients, and on the confidence of ward nurses caring for them.* The aim of the project was to pilot a nursing tool, comprising a colour-coded observation chart and response algorithm, to support ward nurses in the early identification of, and rapid response to deteriorating patients on two general wards.* The setting for the study was a tertiary, acute private hospital in Brisbane, with 323 beds. The pilot study was carried out on a 30-bed neurovascular ward and 41-bed orthopaedic ward from October to December 2007.* Implementation of the new system improved clinical outcomes for patients on the pilot wards. Compliance with documentation was very high and nurses' satisfaction with all aspects of the new system was extremely high. The modified early warning system was considered a valid tool, valuable in supporting ward nurses in the care of critically ill patients and the system was extended to all hospital wards after the pilot.