Is the Early Warning Score (EWS) Needed?

Communication and Documentation
1. Are the charts clear?
2. Competency
3. Training
4. Confidence in talking to the doctor
5. Reassure the patient
Manual or electronic? (3)
1. Competence
  1. Human error (8)
Response to score
1. Healthcare assistant reporting to the nurse
  1. Leave the patient alone?
    1. Nurse reports to the doctor?
      1. Doctor reviews the patient?
2. How often?
  1. Dependent of the score
Blood pressure
1. Choosing the right size cuff
Respiratory rate
1. Patients awareness
  1. Depth and Rhythm
    1. Tachypnoea/Bradypnoea/Apnoea
    2. Using accessory muscles
      1. Reposition
    3. Pain
      1. Analgesia
        Reassess
  2. Secret check
Assessment
1. Temperature
2. Pulse
  1. Manual or electronic
  2. Amplitude (Volume)
    1. Weak and thready
      1. ypovolaemia, cardiogenic shock
        Intravenous fluids
    2. Bounding puise
      1. Sepsis, carbon dioxide retention
        Administer oxygen
        Intravenous fluids
        blood cultures
        monitor output (12)
    3. Irregular
      1. Cardiac arrhythmia
  3. Affecting factors
    1. Age/Gender/Exercise/Fever/Medications/Hypovolaemia/Stress/Position/Pathology (1)
3. Palliative patients
  1. Should the be scored?
4. Alert, Verbal, Pain, Unresponsiveness (AVPU) (11)
5. Output
6. Oxygen saturation
  1. Chronic Obstructive Pulmonary Disorder (COPD)
  2. Carbon Monoxide poisoning (4)
training
1. Equipment
2. Knowledge
  1. Are we being de-skilled?
3. Compliance
Ethical issues
1. Educate the patient
2. Patients understanding
  1. Patient declines...What next?
    1. Consent
3. Mental Capacity Act (MCA) (2005) REFERENCE
4. Accountability
Contraindications
1. Pregnancy, under 16's
  1. Physiological response differs
2. Chronic Obstructive Pulmonary Disorder
  1. Disturbed physiology
    1. Oxygen saturations 88-92%
3. Glasgow Coma Scale (GCS) (11)
Guidelines
1. National Institute of Health and Care Excellence (NICE) (7)
2. Evidence Based Practice
3. Cost Effectiveness
4. Trust policy
5. Royal College of Physicians (3)
  1. Score 1-4 monitor 4-6 hourly
  2. Score 5-6 monitor hourly
  3. Score 7+ monitor constantly
Patient centered care
1. Health promotion
  1. Causes of hypertension (13)
    1. Salt/exercise/smoking/alcohol/weight/stress (2, 13)
2. Saving lives (9)
Clinical judgment
1. How often?
  1. Patient safety
  2. Knowledge base
2. Red flags
  1. Hypertension
    1. Whitecoat syndrome (3)
  2. Pyrexia
  3. Oxygen saturation
    1. Positioning
  4. Altered respiratory
    1. Patients awareness
  5. Tacycardia/Bradycardia
    1. Reassurance
  6. Alert, Verbal. Pain. Unresponsive
    1. Glasgow Coma Scale
  7. Pain (10)
3. Is the early warning score a substitute for clinical judgement (6)
Student Number: 10021107

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Is the Early Warning Score (EWS) Needed?

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	Creado por smartie1973 hace más de 10 años