Are Early Warning Scores documented accurately and correctly by nurses: A Critical Review

Aim: The aim of this dissertation is to critically review the literature surrounding the accuracy of nurses’ documentation of the EWS. This critical review aims to examine the quality and methods of the current research on EWS documentation and whether these can be enhanced in any way. Background: Assessment tools, such as the EWS, implemented in nursing care are vital due to their preventative nature. Instruments such as the EWS are viewed as highly integral in assessing, planning and implementing the correct care for a patient. However, policies and research identify that nurses do not comply with the guidelines and protocol for the use of the EWS. The relationship between increased rates of mortality and the number of physiological abnormalities is directly proportional, therefore, if abnormal observations are detected and reported by the nurse then mortality rates within the hospital setting should be reduced. The EWS plays a great role in this; however, it needs to be implemented correctly by the nurse to aid patient care and safety in a significant manner. Method: A critical review was employed to meet the aim of this dissertation. This method was chosen instead of a systematic review as systematic reviews process large quantities of existing research however, the topic of EWS is quite under researched; therefore a critical review seemed more appropriate. Results: EWS documentation is poor and often incomplete. The RR is especially neglected when recording vital signs. Although training programmes are put into place they do not always result in changing staff behaviour. Conclusion: Overall, EWS documentation needs to improve. It is recommended that more qualitative research be conducted, teamed with theoretical frameworks, to find out why documentation is poor. Also, to give research more merit RCTs would be useful too