Using an Early Warning Score for Nurse Shift Patient Handover: Before-and-after Study

Area of Science:

• Nursing
• Patient Safety
• Healthcare Quality Improvement

Background:

• Effective patient handover is critical for safe care transitions.
• Early warning scores (EWS) are used to identify at-risk patients.
• The impact of EWS on handover processes and outcomes requires further investigation.

Purpose of the Study:

• To evaluate the effect of an early warning score during patient handover on nurse and patient outcomes.
• To assess changes in safety competency, handover quality, teamwork, safety climate, and documentation.
• To examine patient outcomes including deterioration, hospitalization length, and adverse events.

Main Methods:

• A before-and-after study in a tertiary teaching hospital.
• Implementation of the National Early Warning Score 2 (NEWS2) and a checklist for nurse education.
• Data collected via questionnaires and medical record reviews from 89 nurses and 388 patients.

Main Results:

• Significant improvements observed in handover quality, teamwork, safety climate, and vital sign/clinical concern documentation post-intervention.
• No significant changes noted in nurse safety competency.
• No significant differences in patient outcomes such as deterioration, hospitalization length, or adverse events.

Conclusions:

• The early warning score intervention positively impacted socio-cultural aspects of patient safety and nurse monitoring during handover.
• While direct patient outcome improvements were not statistically significant, the findings support the use of EWS for enhancing patient safety culture.
• Evidence supports the active implementation of early warning scores to bolster patient safety practices.