Impact of introducing an electronic physiological surveillance system on hospital mortality

Strengths and limitations of early warning scores: A systematic review and narrative synthesis

“…72 Schmidt et al associated the use of such technology with reduced patient mortality. 73 A before-and-after controlled trial of 18 305 patients investigated the effects of automated vital signs monitors 74 and found their introduction to be associated with increased survival to discharge from 86% to 92% in patients receiving rapid response team calls. The same study noted that there was also a decrease in the time required for vital signs measurement and recording, from 4.1 minutes to 2.5 minutes.…”

Can binary early warning scores perform as well as standard early warning scores for discriminating a patient's risk of cardiac arrest, death or unanticipated intensive care unit admission?

“…We excluded data from patients aged <16 years at hospital admission and patients discharged alive on the day of admission. Vital signs data were recorded in real-time at the bedside using handheld electronic equipment running Vital-PAC software [12,13]. Each full set of vital signs measurements contained: pulse rate, breathing rate, systolic and diastolic blood pressure, temperature, S p O 2 , the inspired gas (e.g., oxygen or air) at the time of S p O 2 measurement, and the patient's conscious level.…”

“…There are clear strengths to our study-it uses a large database from over 18 months of completed, hospital-wide inpatient admissions and all necessary vital signs variables were collected simultaneously in a standardised manner for all observations sets, using an electronic data collection system [12,13]. However, there are also weaknesses.…”

“…Further investigation into the rates and implications of errors using standard EWSs, and the potential to reduce error with a binary EWS are required to determine whether binary systems might offer better performance and safety in clinical practice. In hospitals where EWSs are calculated electronically [12,13,24,25], a simplified EWS would offer no obvious benefit, as electronic systems remove errors due to inaccurate calculation or inaccurate assignment of score. Introducing Binary NEWS in such settings would likely merely increase staff workload.…”

Factors Influencing Registered Nurses’ Decision to Activate an Adult Rapid Response Team in a Community Hospital

“…In an effort to improve identification of objective criteria indicating clinical deterioration, objective data, real-time alerts to nursing staff, and automated monitors have been implemented with conflicting impact on outcome measures. 15,[20][21][22][23] The activation of the RRT is likely based not only on objective information but also on the nurse forming a clinical judgment about the situation and seeking assistance within the context of their organizational cultures.…”