Early Warning Score Communication Bundle: A Pilot Study.

Area of Science:

• Nursing
• Clinical Informatics
• Patient Safety

Background:

• Unplanned intensive care unit (ICU) admissions often stem from delayed recognition of clinical deterioration on medical-surgical units.
• Early warning scores (EWS) are crucial for nurse surveillance but require effective communication and implementation.
• Collaboration with experienced ICU nurses can mitigate unplanned patient transfers.

Purpose of the Study:

• To evaluate the impact of an EWS communication bundle on medical-surgical to ICU transfers.
• To assess the effect on rapid response team (RRT) calls and patient morbidity post-ICU transfer.

Main Methods:

• An EWS was electronically integrated into medical records.
• A communication bundle involving nurse notification and telephone collaboration was implemented.
• Data were collected pre- and post-implementation over a 24-month period.

Main Results:

• Intensive care unit admissions following RRT calls significantly declined (P = .03).
• Admissions for patients with EWS > 4 also significantly decreased (P = .01), indicating earlier intervention.
• Documented reassessment response time significantly improved, decreasing to 28 minutes (P = .002).

Conclusions:

• Electronic surveillance combined with ICU nurse collaboration enhances patient care and reduces costs.
• Experienced critical care nurses play a vital role in mentoring less experienced staff.
• This approach demonstrates potential for improving patient outcomes and operational efficiency.