Implementation of the National Early Warning Score Tool in the Acute Care Setting

Practice Problem: The organization arbitrarily called a rapid response or code blue call based on abnormal vital signs or intuition and needed a new process to identify early recognition of patient deterioration PICOT: For adult inpatients in an acute care setting in a large healthcare system (P), will implementation of the National Early Warning Score (NEWS) across the organization (I) compared to data from the last fiscal year where NEWS was not used (C) decrease code blue calls (O) within 8-weeks (T)? Evidence: Eleven high quality studies met the inclusion criteria and found that the NEWS is a validated track and trigger tool, which promotes early detection of patients’ clinical deterioration and more accurate rapid response calls. Intervention: Staff fulfilled virtual training on completion of the NEWS tool within the computerized patient record system. Chart audits were conducted to measure compliance with the number of times the NEWS tool was used to trigger an event, and the number of times the trigger was missed. Outcome: The result of the two-tailed paired samples t-test was not statistically significant for rapid response calls. However, the clinical significance of NEWS implementation was that there was an increase in rapid responses and a decrease in code blue responses post NEWS implementation. Conclusion: The NEWS tool provided accurate identification of clinical deterioration to improve patient outcomes.