Anaesthesiology Department Z, Bispebjerg Hospital, Copenhagen, Denmark.
PLoS One. 2013 Jul 26;8(7):e70068. doi: 10.1371/journal.pone.0070068. Print 2013.
In 2007, the initiation of a patient safety campaign led to the introduction of Ward Observational Charts (WOC) and Medical Early Warning Score (MEWS) at Naestved Regional Hospital. This included systematic measuring of vital signs of all patients in order to prevent patient deterioration and assure timely and correct initiation of treatment. The aim of this study was to assess to what degree WOC guidelines being followed by ward staff.
A 7-day prospective, observational, randomised, cross-sectional, point prevalence study of WOC guideline compliance in hospitalised patients on twelve wards at Naestved Hospital.
The study included 132 patients. Of these, 58% had been observed and managed correctly according to WOC guidelines. 77% had all MEWS elements recorded by staff. One patient had no MEWS elements recorded. Only 38% of patients with abnormal MEWS were correctly escalated by nursing staff. Staff was aware of the abnormal MEWS observed by investigator in 60% of the patients. Each element of WOC was on average recorded by staff in 90% of the patients.
At the time of our study, the long-term implementation of WOC guidelines has not been completed satisfactorily. The lacking component in the implementation of MEWS and WOC is the documentation of action taken upon finding an abnormal value. Unsuccessful implementation could result in incorrect results from evaluation of an early warning system. We suggest a redesign of the training programme to educate staff in recognising and caring for critically ill patients at Naestved Hospital.
2007 年，发起了一项患者安全运动，导致 Naestved 地区医院引入了病房观察表（WOC）和医疗早期预警评分（MEWS）。这包括系统地测量所有患者的生命体征，以防止患者恶化，并确保及时和正确地开始治疗。本研究的目的是评估病房工作人员遵循 WOC 指南的程度。
这是一项为期 7 天的前瞻性、观察性、随机、横断面、时点患病率研究，旨在评估 Naestved 医院 12 个病房住院患者的 WOC 指南依从性。
该研究共纳入 132 例患者。其中，58%的患者按照 WOC 指南得到了正确的观察和管理。77%的患者由工作人员记录了所有 MEWS 元素。有 1 例患者未记录 MEWS 元素。仅有 38%的异常 MEWS 患者被护理人员正确升级。工作人员在 60%的患者中意识到了调查员观察到的异常 MEWS。平均而言，工作人员在 90%的患者中记录了 WOC 的每个元素。
在我们进行研究时，WOC 指南的长期实施并不令人满意。在 MEWS 和 WOC 的实施中缺乏的是对发现异常值所采取的行动的记录。实施不成功可能导致对早期预警系统的评估结果不正确。我们建议重新设计培训计划，以教育 Naestved 医院的工作人员识别和护理危重症患者。
