Journal of nursing care quality · 2026
Enhancing Nurses' Capability to Promptly Escalate Care Using the Early Warning Score: A Quality Improvement Initiative.
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Er Joyce, Ang Emily, Yue Lai Theng, Thornlow Deirdre K
Аннотация
BACKGROUND: Clinical deterioration in general ward patients is largely preventable with early recognition of abnormal vital signs and prompt escalation of care.
LOCAL PROBLEM: Limited knowledge of the early warning score (EWS) and an inability to recognize and respond to clinical deterioration among general ward nurses led to delays in escalation of care.
METHODS: This quality improvement project used iterative Plan-Do-Study-Act cycles. Outcomes included knowledge, EWS protocol compliance, and care escalation for patients with an EWS score ≥5 to prevent further deterioration.
INTERVENTIONS: A mandatory educational program was implemented with Plan-Do-Study-Act cycles to test and refine practice changes.
RESULTS: Nurses' knowledge improved significantly post-education (P < .001). EWS protocol compliance and care escalation increased.
CONCLUSIONS: EWS education improved nurses' compliance with protocols and escalation of care, supporting early recognition of clinical deterioration and prevention of serious adverse events.
LOCAL PROBLEM: Limited knowledge of the early warning score (EWS) and an inability to recognize and respond to clinical deterioration among general ward nurses led to delays in escalation of care.
METHODS: This quality improvement project used iterative Plan-Do-Study-Act cycles. Outcomes included knowledge, EWS protocol compliance, and care escalation for patients with an EWS score ≥5 to prevent further deterioration.
INTERVENTIONS: A mandatory educational program was implemented with Plan-Do-Study-Act cycles to test and refine practice changes.
RESULTS: Nurses' knowledge improved significantly post-education (P < .001). EWS protocol compliance and care escalation increased.
CONCLUSIONS: EWS education improved nurses' compliance with protocols and escalation of care, supporting early recognition of clinical deterioration and prevention of serious adverse events.