Nadaf Claire, Bench Suzanne, Halpin Yvonne, Terry Louise
Health Sciences University, Bournemouth, UK.
London South Bank University, London, UK.
J Adv Nurs. 2025 Aug;81(8):4871-4882. doi: 10.1111/jan.16656. Epub 2024 Dec 6.
To explore Registered Nurses' experiences and perceptions of using the National Early Warning Score in the U.K. as part of the recognition and management of acute adult patient deterioration.
Hermeneutic Phenomenological design.
Sixteen Registered Nurses from a U.K. NHS hospital were interviewed using an interpretative phenomenological approach (2019-2020).
Registered Nurses' use of NEWS highlighted 3 risk areas: delegation of vital sign monitoring to unregistered staff leading to uncertainty and delayed escalation, junior nurses' over-reliance on NEWS and deference to expertise, and senior nurses' self-management of deteriorating patients. The workplace culture revealed frequent compromises and limited learning opportunities.
When using NEWS, failure to recognise associated risks threatens patient safety. Wrong decisions at the three 'pinch points' may lead to missed chances in preventing deterioration. Incorrect judgements may lead to unrecognised patient deterioration or inappropriate management leading to preventable adverse events.
The way in which NEWS is used by healthcare professionals brings inherent patient safety risks. Addressing education gaps and fostering a supportive culture in nursing, valuing and enhancing nurses' clinical judgement, is crucial for mitigating these risks and ensuring patient safety.
The study deepens understanding of nurses' use of NEWS and identifies components affecting the recognition of patient deterioration.
Adherence to the EQUATOR guidelines SRQR confirmed.
Service user involvement was included within the design of the study and ethical approval.
探讨英国注册护士在识别和管理成年急性病患者病情恶化时使用国家早期预警评分（National Early Warning Score，NEWS）的经验和看法。
诠释现象学设计。
采用解释性现象学方法对英国一家国民保健服务（NHS）医院的16名注册护士进行了访谈（2019 - 2020年）。
注册护士使用NEWS突出了3个风险领域：将生命体征监测工作委托给非注册人员导致不确定性和病情升级延迟；初级护士过度依赖NEWS并听从专业意见；高级护士对病情恶化患者的自我管理。工作场所文化显示出频繁的妥协和有限的学习机会。
在使用NEWS时，未能识别相关风险会威胁患者安全。在三个“关键点”上的错误决策可能导致错过预防病情恶化的机会。错误判断可能导致未被识别的患者病情恶化或管理不当，从而引发可预防的不良事件。
医护人员使用NEWS的方式带来了固有的患者安全风险。弥补教育差距并在护理工作中营造支持性文化，重视并提高护士的临床判断力，对于降低这些风险和确保患者安全至关重要。
该研究加深了对护士使用NEWS的理解，并确定了影响识别患者病情恶化的因素。
确认符合EQUATOR指南SRQR。
服务使用者参与了研究设计和伦理审批。
