Enhancing Nurses’ Capability to Promptly Escalate Care Using the Early Warning Score

Abstract

Background: Clinical deterioration in general ward patients is largely preventable with early recognition of abnormal vital signs and prompt escalation of care. Local Problem: Limited knowledge of the early warning score (EWS) and an inability to recognize and respond to clinical deterioration among general ward nurses led to delays in escalation of care. Methods: This quality improvement project used iterative Plan-Do-Study-Act cycles. Outcomes included knowledge, EWS protocol compliance, and care escalation for patients with an EWS score ≥5 to prevent further deterioration. Interventions: A mandatory educational program was implemented with Plan-Do-Study-Act cycles to test and refine practice changes. Results: Nurses’ knowledge improved significantly post-education ( P < .001). EWS protocol compliance and care escalation increased. Conclusions: EWS education improved nurses’ compliance with protocols and escalation of care, supporting early recognition of clinical deterioration and prevention of serious adverse events.