Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country

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dc.contributor.authorKyriacos, Unaen_ZA
dc.contributor.authorJelsma, Jenniferen_ZA
dc.contributor.authorJames, Michaelen_ZA
dc.contributor.authorJordan, Sueen_ZA
dc.date.accessioned2015-12-28T06:46:53Z
dc.date.available2015-12-28T06:46:53Z
dc.date.issued2014en_ZA
dc.description.abstractObjective The aim of the study was to develop and validate, by consensus, the construct and content of an observations chart for nurses incorporating a modified early warning scoring (MEWS) system for physiological parameters to be used for bedside monitoring on general wards in a public hospital in South Africa. METHODS: Delphi and modified face-to-face nominal group consensus methods were used to develop and validate a prototype observations chart that incorporated an existing UK MEWS. This informed the development of the Cape Town ward MEWS chart. Participants One specialist anaesthesiologist, one emergency medicine specialist, two critical care nurses and eight senior ward nurses with expertise in bedside monitoring (N = 12) were purposively sampled for consensus development of the MEWS. One general surgeon declined and one neurosurgeon replaced the emergency medicine specialist in the final round. RESULTS: Five consensus rounds achieved ≥70% agreement for cut points in five of seven physiological parameters respiratory and heart rates, systolic BP, temperature and urine output. For conscious level and oxygen saturation a relaxed rule of <70% agreement was applied. A reporting algorithm was established and incorporated in the MEWS chart representing decision rules determining the degree of urgency. Parameters and cut points differed from those in MEWS used in developed countries. CONCLUSIONS: A MEWS for developing countries should record at least seven parameters. Experts from developing countries are best placed to stipulate cut points in physiological parameters. Further research is needed to explore the ability of the MEWS chart to identify physiological and clinical deterioration.en_ZA
dc.identifier.apacitationKyriacos, U., Jelsma, J., James, M., & Jordan, S. (2014). Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country. <i>PLoS One</i>, http://hdl.handle.net/11427/16021en_ZA
dc.identifier.chicagocitationKyriacos, Una, Jennifer Jelsma, Michael James, and Sue Jordan "Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country." <i>PLoS One</i> (2014) http://hdl.handle.net/11427/16021en_ZA
dc.identifier.citationKyriacos, U., Jelsma, J., James, M., & Jordan, S. (2013). Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country. PloS one, 9(1), e87073-e87073. doi:10.1371/journal.pone.0087073en_ZA
dc.identifier.ris TY - Journal Article AU - Kyriacos, Una AU - Jelsma, Jennifer AU - James, Michael AU - Jordan, Sue AB - Objective The aim of the study was to develop and validate, by consensus, the construct and content of an observations chart for nurses incorporating a modified early warning scoring (MEWS) system for physiological parameters to be used for bedside monitoring on general wards in a public hospital in South Africa. METHODS: Delphi and modified face-to-face nominal group consensus methods were used to develop and validate a prototype observations chart that incorporated an existing UK MEWS. This informed the development of the Cape Town ward MEWS chart. Participants One specialist anaesthesiologist, one emergency medicine specialist, two critical care nurses and eight senior ward nurses with expertise in bedside monitoring (N = 12) were purposively sampled for consensus development of the MEWS. One general surgeon declined and one neurosurgeon replaced the emergency medicine specialist in the final round. RESULTS: Five consensus rounds achieved ≥70% agreement for cut points in five of seven physiological parameters respiratory and heart rates, systolic BP, temperature and urine output. For conscious level and oxygen saturation a relaxed rule of <70% agreement was applied. A reporting algorithm was established and incorporated in the MEWS chart representing decision rules determining the degree of urgency. Parameters and cut points differed from those in MEWS used in developed countries. CONCLUSIONS: A MEWS for developing countries should record at least seven parameters. Experts from developing countries are best placed to stipulate cut points in physiological parameters. Further research is needed to explore the ability of the MEWS chart to identify physiological and clinical deterioration. DA - 2014 DB - OpenUCT DO - 10.1371/journal.pone.0087073 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country TI - Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country UR - http://hdl.handle.net/11427/16021 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16021
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0087073
dc.identifier.vancouvercitationKyriacos U, Jelsma J, James M, Jordan S. Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country. PLoS One. 2014; http://hdl.handle.net/11427/16021.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDivision of Nursing and Midwiferyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2014 Kyriacos et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherNursesen_ZA
dc.subject.otherChartsen_ZA
dc.subject.otherHeart rateen_ZA
dc.subject.otherPhysiological parametersen_ZA
dc.subject.otherUrineen_ZA
dc.subject.otherOxygenen_ZA
dc.subject.otherCritical care and emergency medicineen_ZA
dc.subject.otherSystematic reviewsen_ZA
dc.titleMonitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing countryen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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