Mandatory early warning scoring-implementation evaluated with a mixed-methods approach.

Aim: The aim of this study was to evaluate adherence to an intervention optimizing in-hospital monitoring practice, by introducing early warning scoring (EWS) of vital parameters. Background: Interventions comprising EWS systems reduce in-hospital mortality, but evaluation of adherence to such inter...

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Publicado en:Applied Nursing Research Vol. 29; pp. 168 - 177
Autores principales: Bunkenborg, Gitte, Poulsen, Ingrid, Samuelson, Karin, Ladelund, Steen, Akeson, Jonas
Formato: algorithm forms research tables/charts Journal Article
Publicado: Elsevier B.V. Feb2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2016
      vid: 29
      pid: 82545
      pub: Elsevier B.V.
      place: Philadelphia, Pennsylvania
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        116434300
        116434300
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        10.1016/j.apnr.2015.06.012
        116434300
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        atl: Mandatory early warning scoring-implementation evaluated with a mixed-methods approach.
      aug:
        au:
          Bunkenborg, Gitte
          Poulsen, Ingrid
          Samuelson, Karin
          Ladelund, Steen
          Akeson, Jonas
        affil: Department of Anaesthesiology, Copenhagen University Hospital, Hvidovre, Denmark
      sug:
        subj:
          Program Implementation Evaluation
          Early Intervention
          Professional Competence Evaluation
          Vital Signs Evaluation
          Nurse Attitudes Evaluation
          Human
          Evaluation Research
          Time Factors
          Motivation
          Experimental Studies
          Semi-Structured Interview
          Multimethod Studies
          Hospital Units Denmark
          Denmark
          Pretest-Posttest Design
          Algorithms Utilization
          Kaplan-Meier Estimator
          Confidence Intervals
          Heart Rate Evaluation
          Blood Pressure Determination
          Body Temperature Determination
          Nurse Managers
          Adult
          Audiorecording
          Content Analysis
          Triangulation
          Thematic Analysis
          Nursing Assessment
          Clinical Assessment Tools
          Funding Source
          Adult: 19-44 years
      ab: Aim: The aim of this study was to evaluate adherence to an intervention optimizing in-hospital monitoring practice, by introducing early warning scoring (EWS) of vital parameters. Background: Interventions comprising EWS systems reduce in-hospital mortality, but evaluation of adherence to such interventions is required to correctly interpret interventional outcome. Method: Adherence was evaluated with a mixed-methods approach. Quantitative data, obtained pre-interventionally (2009) and postinterventionally (2010 and 2011), were used to calculate and compare time intervals between scorings of vital parameters. Semi-structured interviews were used to evaluate the implementation process. Results: We found significant reductions in time intervals between measurements of vital parameters in 2011 compared to 2009. Scorings of vital parameters were repeated within 8 hours in 71-77% of patients scoring total modified EWS levels of 0,2 or 4. The theme Motivation by clinical relevance and meaningfulness was identified as crucial to the implementation process. Conclusion: High adherence to an intervention may be strongly related to nurses' perceived clinical relevance of the intervention.
      pubtype: Academic Journal
      doctype:
        algorithm
        forms
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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