Abstract 15308: Impact on the Implementation of Early Warning Score in the Cardiology Ward
Backgrounds: National early warning score (NEWS) was developed in United Kingdom to facilitate the early identification and response to deteriorating patients. NEWS is a calculation of an aggregate trigger score based on patient’s vital signs (blood pressure, pulse, respirations etc.). Patients in the cardiology ward tend to have higher NEWS; however it has not been evaluated that NEWS prevents the in-hospital cardiac pulmonary arrest in the cardiology ward. We investigated whether the implementation of NEWS system reduced the unanticipated death in the cardiology ward.
Methods: NEWS system was introduced in our hospital in January 2015. NEWS was categorized as a low score (NEWS of 1-4), a medium score (5-6) and a high score (7 or more) and those scores determined the urgency of the clinical response. In our ward, when scores were more than 5, nurses called cardiologists for the first intervention. We compared the in-hospital unanticipated death rate in the cardiology ward between the year of 2014 and 2015.
Results: There were 1284 admissions (66 heart failure, 46 acute myocardial infarction (AMI), 427 percutaneous coronary intervention (PCI)) in 2014, while 1474 (78 heart failure, 55 AMI, 496 PCI) patients were admitted in 2015 (P=0.99). No statistical differences were seen in the mortality (21/1284 patients (1.6%) in 2014 vs. 18/1474 (1.2%) in 2015; p=0.36) and the unanticipated death rate (1/1284 (0.07%) in 2014 vs. 5/1474 (0.34%) in 2015; p=0.14) between two years. One unanticipated death in 2014 was caused by a sudden onset of pulmonary embolism. Her vital signs were normal before the incident. NEWS of three unanticipated death in 2015 were lower than 3 in the hours before the incidents. They also died due to sudden onset diseases.
Conclusions: The implementation of the NEWS system did not reduce the death and the unanticipated death in the cardiology ward; however it remains unclear that the number of patients who were rescued by the quick response in NEWS system.
Author Disclosures: S. Takahashi: None. M. Harasawa: None. M. Nakatsuka: None. N. Shinozaki: None.
- © 2016 by American Heart Association, Inc.