Monitoring vital signs using early warning scoring system as a part of patient’s safety- revive of the literature

Abstract

MONITORING VITAL SIGNS USING EARLY WARNING SCORING SYSTEM AS A PART OF PATIENT’S SAFETY- REVIVE OF THE LITERATURE

Introduction. Significant advance in medical since has been made over the years but have not improved on the survival patients in-hospital cardiac arrest. The current research shows that many patients in-hospital cardiac arrest is preceded by changes in the values of vital signs for a few hours before cardiac arrest. For that purpose, a wide range of scales for early detection of conditions associated with heart failure, respiratory or central nervous system functioning.

Aim. To assess the need for Polish hospitals in Early Warning Score in patients hospitalized outside the centres, intensive care or supervision by reviewing the latest literature.

Methods. Review of the publication of the last 5 years, in English, using sophisticated electronic databases Pub Med, the Early Warning Score system in adult patients hospitalized outside the centres of intensive care or supervision.

Results. 50 original papers were included in the review. It was shown that EWS systems help to identify the deteriorating patient. There are studies that show that the mortality of patients hospitalized in wards, which is not carried out continuous monitoring of vital signs is greater than in wards holding the intensive monitoring of the number of studies indicates the need for monitoring of vital signs, especially in patients at risk. However, such systems have limits. There are studies that show that lack of proper training of nursing staff and limits the effectiveness of the system. Mentioned most frequently evaluated criteria for assessing a patient in critical condition, such as the number of breaths of <5 or> 36, heart rate <40 or> 140 ud / min, systolic blood pressure below 90 mm Hg, a decrease of 2 points. GCS score or more, repeated or prolonged seizures, as well as any patient whose condition begins to worry us, but it does not meet these criteria.

Conclusions. Better monitoring means better care. However, there is a need for further research on EWS systems in order to better define and understand the issues. Extremely important is education of nursing personnel holding direct patient care.