Bedside vital parameters that indicate early deterioration.
Purpose: The purpose of this paper is to determine associations between initially recorded deviations in individual bedside vital parameters that contribute to total Modified Early Warning Score (MEWS) levels 2 or 3 and further clinical deterioration (MEWS level=4).Design/methodology/approach: This...
| Publicado en: | International Journal of Health Care Quality Assurance (09526862) Vol. 32; no. 1; pp. 262 - 273 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
Emerald Publishing Limited
2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=135266007&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 135266007 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09526862 CQA jtl: International Journal of Health Care Quality Assurance (09526862) issn: 09526862 maglogo: N pubinfo: dt: 2019 vid: 32 iid: 1 pid: 465 pub: Emerald Publishing Limited artinfo: ui: 135266007 135266007 NLM30859885 135266007 10.1108/IJHCQA-10-2017-0206 NLM30859885 135266007 ppf: 262 ppct: 11 formats: tig: atl: Bedside vital parameters that indicate early deterioration. aug: au: Bunkenborg, Gitte Poulsen, Ingrid Samuelson, Karin Ladelund, Steen Akeson, Jonas affil: Department of Anaesthesiology, Copenhagen University Hospital, Copenhagen, Denmark sug: subj: Hospital Mortality Disease Progression Academic Medical Centers Vital Signs Length of Stay Adult Inpatients Middle Age Denmark Male Aged Aged, 80 and Over Sweden Logistic Regression Cox Proportional Hazards Model Prospective Studies Female Time Factors Human Risk Assessment Age Factors Validation Studies Comparative Studies Evaluation Research Multicenter Studies Questionnaires Scales Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Purpose: The purpose of this paper is to determine associations between initially recorded deviations in individual bedside vital parameters that contribute to total Modified Early Warning Score (MEWS) levels 2 or 3 and further clinical deterioration (MEWS level=4).Design/methodology/approach: This was a prospective study in which 27,504 vital parameter values, corresponding to a total MEWS level⩾2, belonging to 1,315 adult medical and surgical inpatient patients admitted to a 90-bed study setting at a university hospital, were subjected to binary logistic and COX regression analyses to determine associations between vital parameter values initially corresponding to total MEWS levels 2 or 3 and later deterioration to total MEWS level ⩾4, and to evaluate corresponding time intervals.Findings: Respiratory rate, heart rate and patient age were significantly ( p=0.012, p<0.001 and p=0.028, respectively) associated with further deterioration from a total MEWS level 2, and the heart rate also ( p=0.009) from a total MEWS level 3. Within 24 h from the initially recorded total MEWS levels 2 or 3, 8 and 17 percent of patients, respectively, deteriorated to a total MEWS level=4. Patients initially scoring MEWS 2 had a 27 percent 30-day mortality rate if they later scored MEWS level=4, and 8.7 percent if they did not.Practical Implications: It is important to observe all patients closely, but especially elderly patients, if total MEWS levels 2 or 3 are tachypnoea and/or tachycardia related.Originality/value: Findings might contribute to patient safety by facilitating appropriate clinical and organizational decisions on adequate time spans for early warning scoring in general ward patients. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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