Early Warning Score

Rosalina
1906428505
Faculty Of Nursing 2019/2020
Why Is Early Warning Score
So Important For Nurse?
Signs of deterioration / worsening of
conditions appear 6-8 hours before the
patient experiences emergency (cardiac
arrest)
OUTLINE

Definition EWS

3 Element EWS

How To Use?
 Early Warning
Score

.EWS is an evidenced based system of care,

used in hospitals to monitor the progress
of patients, and to identify early
deterioration in their health.
(West London Mental Health, 2018)

EWS is a form of track and trigger scoring system. The

triggers are based on routine observations and are
sensitive enough to detect subtle changes in a patient’s
physiology which will be reflected in a change of score
should the patient be improving or deteriorating.
3 Element EWS
 Early Detection

Standardization of detection techniques

deterioration of the patient's condition.

Blood Respiration
Pressure Rate
What
Should be
detected? Body
Heart Rate
Temperature

Level Of
Conciusness
 Timeliness Of
Response

Standardization the level of deterioration

patient's condition

Green (stable)

Yellow (deterioration conditions)

Orange (worsening conditions)

Red (Emergency)
 Competency

Helping to make clinical decision quickly

and accurately

who made the

decision?
How To Use

Assement Clinical Signs

(Vital Signs)

Scoring EWS

Classify EWS Category

EWS Algorithm
EWS Adult
 EWS Algorithm

Green (0-1)

• The patient's condition is stable

• Monitor and review EWS scores 1x per shift
 EWS Algorithm

Yellow (2-3)

• Reviewed scores by Primary Nurse / Team Leader

• Determine the problem and action to overcome it
• Monitor and reassess EWS scores every 2 hours
 EWS Algorithm

Orange (4-5)

• Reviewed the score by Primary Nurse / Team Leader,

known by medical team
• Doctors determine the actions according to the patient's
condition
• Monitor and reassess the EWS every 1 hour
• Consider to transfer to the intensive care / high care unit
 EWS Algorithm

Red (≥6)

• Activate Code Blue, Code Blue Team handles patient

emergency
• The doctors are stand by beside the patient, collaborating to
determine the next treatment plan
• Monitor the patient's condition during the emergency
situation
 Case examples

You find 40-years-old patient with:

Level of Consciousness : Pain

Breathing Frequency : 26x / Minute
Systolic Blood Pressure : 130/90 mmHg
Pulse Frequency : 104x / Minute
Body Temperature : 37.3 °C
Answer
Orange (4-5)

Total Score : 5 (EWS category is Orange)

Conclusion

“Early detection of changes in the patient's

condition is very important, because delay in
initiating appropriate actions can have a
negative impact on patient care”