Center of Diakonia and Professional Practice, VID Specialized University, Oslo, Norway.
Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
J Clin Nurs. 2019 Dec;28(23-24):4389-4399. doi: 10.1111/jocn.15021. Epub 2019 Aug 29.
To explore general hospital ward nurses' experiences with the National Early Warning Score and to determine its impacts on their professionalism.
The National Early Warning Score has broad appeal; it is a patient safety initiative designed to ensure early identification of and response to deteriorating patients in hospitals. However, it is still unclear how the tool impacts nurses' professionalism.
A qualitative study with a hermeneutic design was conducted in autumn 2017; the study consisted of semi-structured, in-depth interviews with 14 hospital nurses. The data were analysed thematically to understand and interpret the nurses' experiences. Methods are reported using COREQ guidelines (see Appendix S1).
The study examined nurses' experience with the National Early Warning Score and its perceived impact on their professionalism. Four themes were identified: (a) the National Early Warning Score and clinical judgement in patient assessment, (b) responding to the National Early Warning Score standard, (c) involving the professional community and (d) adjusting the tool.
The National Early Warning Score may impact nurses' professionalism in diverse ways. Nurses are aware of the importance of incorporating all of their professional competence, comprising clinical judgement, discretion and accountability, with the National Early Warning Score to accurately assess patients' conditions. Findings indicated that the National Early Warning Score was beneficial to nurses' professional practice; however, accountability to this standard alone does not ensure quality care and patient safety.
A greater understanding of the role of nurses' professional accountability when using the National Early Warning Score is needed to improve practice and ensure patient safety.
探讨综合医院病房护士对国家早期预警评分的体验，确定其对护士专业精神的影响。
国家早期预警评分具有广泛的吸引力；它是一项旨在确保医院中病情恶化患者得到早期识别和响应的患者安全倡议。然而，该工具如何影响护士的专业精神仍不清楚。
2017 年秋季进行了一项具有解释学设计的定性研究；研究包括对 14 名医院护士的半结构式深入访谈。使用主题分析方法对数据进行分析，以理解和解释护士的经验。方法按照 COREQ 指南（见附录 S1）报告。
本研究考察了护士对国家早期预警评分的体验及其对专业精神的感知影响。确定了四个主题：（a）国家早期预警评分和患者评估中的临床判断，（b）对国家早期预警评分标准的响应，（c）涉及专业社区，（d）调整工具。
国家早期预警评分可能以多种方式影响护士的专业精神。护士意识到将其所有专业能力，包括临床判断、判断力和问责制，纳入国家早期预警评分，以准确评估患者病情的重要性。研究结果表明，国家早期预警评分有利于护士的专业实践；然而，仅对该标准负责并不能确保高质量的护理和患者安全。
需要更深入地了解护士在使用国家早期预警评分时的专业问责制作用，以改善实践并确保患者安全。
