Intensive & critical care nursing · 2025
Scaling patient safety: How National Early Warning Score 2 (NEWS2) drove systemic mortality reduction in an acute care setting.
СтатьяНазвание и аннотация: Перевод в очереди
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Guo Yang, Zhang Tongyan, Ren Yanyan, Dou Lingshan, Zhu Xiaoshu, Hou Yazhu, Gao Xiumei
Аннотация
OBJECTIVES: To retrospectively assess the impact of the National Early Warning Score 2 (NEWS2) on prognosis in a single-center fever clinic.
METHODS: This was a single-center retrospective study based on real-world data. The period from April 2020-March 2021 was used as the control group, and the period from April 2021-March 2022 was used as the NEWS group to explore the changes in the mortality rates of patients before and after the implementation of the NEWS2. After the use of the NEWS2, as the application time progressed, the changing trend in the difference in the NEWS2 between discharge and admission was explored. In addition, the impact of the difference in the NEWS2 between discharge and admission on the prognosis of patients was explored.
RESULTS: A total of 18,979 patients were included (6,699 in the control group and 12,280 in the NEWS group). The mortality rates in the control group were higher than those in the NEWS group at all time points (0.54 % vs. 0.22 % at 24 h, P < 0.001), (1.06 % vs. 0.55 % at 7 days, P < 0.001), and (1.57 % vs. 0.77 % at 28 days, P < 0.001). The results of multivariate logistic regression indicate that the outcomes remain significant after controlling for confounding factors. The NEWS2 difference increased from April 2021 to March 2022 (-0.64 ± 1.77 vs -0.91 ± 1.68). When the difference in the NEWS between discharge and admission < - 1, the mortality risk decreased.
CONCLUSIONS: Implementing NEWS2 in fever clinics reduced mortality and NEWS2 scores, providing valuable insights for optimizing patient management and enhancing clinical outcomes in fever clinics.
IMPLICATIONS FOR CLINICAL PRACTICE: Incorporating NEWS2 into the routine of fever clinics allows rapid and accurate assessment of patients' conditions. Taking action on the basis of this assessment may contribute to effective resource allocation and personalized care, ultimately improving patient outcomes.
METHODS: This was a single-center retrospective study based on real-world data. The period from April 2020-March 2021 was used as the control group, and the period from April 2021-March 2022 was used as the NEWS group to explore the changes in the mortality rates of patients before and after the implementation of the NEWS2. After the use of the NEWS2, as the application time progressed, the changing trend in the difference in the NEWS2 between discharge and admission was explored. In addition, the impact of the difference in the NEWS2 between discharge and admission on the prognosis of patients was explored.
RESULTS: A total of 18,979 patients were included (6,699 in the control group and 12,280 in the NEWS group). The mortality rates in the control group were higher than those in the NEWS group at all time points (0.54 % vs. 0.22 % at 24 h, P < 0.001), (1.06 % vs. 0.55 % at 7 days, P < 0.001), and (1.57 % vs. 0.77 % at 28 days, P < 0.001). The results of multivariate logistic regression indicate that the outcomes remain significant after controlling for confounding factors. The NEWS2 difference increased from April 2021 to March 2022 (-0.64 ± 1.77 vs -0.91 ± 1.68). When the difference in the NEWS between discharge and admission < - 1, the mortality risk decreased.
CONCLUSIONS: Implementing NEWS2 in fever clinics reduced mortality and NEWS2 scores, providing valuable insights for optimizing patient management and enhancing clinical outcomes in fever clinics.
IMPLICATIONS FOR CLINICAL PRACTICE: Incorporating NEWS2 into the routine of fever clinics allows rapid and accurate assessment of patients' conditions. Taking action on the basis of this assessment may contribute to effective resource allocation and personalized care, ultimately improving patient outcomes.