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The uptake of an early warning system in an Australian emergency department : a pilot study

Considine, Julie, Lucas, Elspeth and Wunderlich, Bart 2012, The uptake of an early warning system in an Australian emergency department : a pilot study, Critical care and resuscitation, vol. 14, no. 2, pp. 135-141.

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Title The uptake of an early warning system in an Australian emergency department : a pilot study
Author(s) Considine, JulieORCID iD for Considine, Julie orcid.org/0000-0003-3801-2456
Lucas, Elspeth
Wunderlich, Bart
Journal name Critical care and resuscitation
Volume number 14
Issue number 2
Start page 135
End page 141
Total pages 7
Publisher Australasian Medical Publishing Company Pty. Ltd.
Place of publication Strawberry Hills, N.S.W.
Publication date 2012-06
ISSN 1441-2772
Keyword(s) Medical care
Emergency medicine
Critical care medicine
Intensive care units
Summary Objectives: To evaluate the uptake of an emergency department early warning system (ED EWS) for recognition of, and response to, clinical deterioration.

Design, setting and participants: A descriptive exploratory study conducted in an urban district hospital in Melbourne, Australia. Systematic sampling was used to identify every 10th patient for whom the ED EWS was activated from May 2009 to May 2011.

Main outcome measures:
Patient characteristics, ED system data and ED EWS activation characteristics.

Results: ED EWS activation occurred in 1.5% of ED patients; 204 patients were included in this pilot study. The median age was 65.1 years (interquartile range [IQR], 47.8-77.5 years), 89.2% of patients were classified as triage category 2 or 3, and 82.4% of patients were seen by medical staff before ED EWS activation. Hypotension (27.7%) and tachycardia (23.7%) were the most common reasons for ED EWS activation. Median duration of clinical instability was 39 minutes (IQR, 5- 129 minutes). Nurses made 93.1% of ED EWS activations. Median time between documenting physiological abnormalities and ED EWS activation was 5 minutes (IQR, 0- 20). Most patients (57.8%) required hospital admission: 4.4% of patients required intensive care unit admission.

Conclusions: The ED EWS resulted in at least two formal reports of clinical deterioration in ED patients per day, indicating reasonable uptake by clinicians. A greater understanding of clinical deterioration in ED patients is warranted to inform an evidence-based approach to recognition of, and response to, clinical deterioration in ED patients.
Language eng
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2012, Australasian Medical Publishing Company Pty. Ltd.
Persistent URL http://hdl.handle.net/10536/DRO/DU:30046082

Document type: Journal Article
Collection: School of Nursing and Midwifery
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Created: Mon, 09 Jul 2012, 11:29:54 EST by Jane Moschetti

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