Is the Early Warning Score (EWS) Needed?

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Mind Map on Is the Early Warning Score (EWS) Needed?, created by smartie1973 on 23/10/2013.
smartie1973
Mind Map by smartie1973, updated more than 1 year ago
smartie1973
Created by smartie1973 over 10 years ago
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Resource summary

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