Evaluation of the Modified Early Warning Scoring System

Not Applicable

Completed

• Conditions: Clinical Deterioration; Nurse's Role; Postoperative Complications
• Interventions: Other: MEWSS and Nursing Guide Application

• Registration Number: NCT05575531
• Lead Sponsor: Kocaeli University

Brief Summary

In this study, it was aimed to determine the effect of HRU and HG on patient outcomes in the care process in surgical patients followed according to MEUSS.

The sample of the study, which was conducted as a randomized-controlled clinical trial, consisted of 252 patients who underwent surgical intervention under general anesthesia in a university hospital between 29 July 2022 and 31 October 2022.

Detailed Description

Postoperative patients are at risk of clinical worsening and minimizing this is vital. Nurses play a vital role in the early detection and management of clinical deterioration as they are the group of professionals with the highest patient contact. MEUSS is stated as a simple risk management tool based on physiological parameters that can allow early detection of clinical deterioration and initiation of the relevant intervention, improving the quality of care and patient safety provided to surgical patients.

In this study, with a larger sample, patients will be followed up with MEUSS and a nursing guide for 2 hours in the clinic where they are transferred both after and after ASBU. Our study is a research with the highest sample in this field, in which patients are followed for the longest period of time, and it is thought that MEUSS and nursing guide applications can identify risky patients in the postoperative period and reduce postoperative complications with strict follow-up applied to these patients. The aim of this study; To determine the effect of Nursing Guide Practice (HRU) and Nursing Interventions (HG) on patient outcomes in the care process in surgical patients followed according to MEUSS.

Study Timeline

• Study Start: 2022-07-29
• Study First Submitted: 2022-10-06
• Study First Submitted QC: 2022-10-08
• Study First Posted: 2022-10-12
• Primary Completion: 2022-10-31
• Study Completion: 2023-01-12
• Status Verified: 2023-03
• Last Update Submitted: 2023-10-06
• Last Update Posted: 2023-10-10

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 220

Inclusion Criteria

• Having operated under general anesthesia
• transferred to the post-anesthesia care unit (ASBU) and then to the service/ICU followed for 2 hours,
• between 18-65 years old,
• who have not had an operation with general anesthesia in the last six months,
• no serious life-threatening complications developed during surgery,
• patients willing to participate in the study

Exclusion Criteria

• data unavailable,
• complications during surgery,
• patients who did not undergo general anesthesia

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Experimental Group	MEWSS and Nursing Guide Application	MEWSS and Nursing Guide Application will be used in the study group. MEWSS: The Modified Early Warning Score (MEWS) consists of a simple to use algorithm based on physiological parameters such as heart rate, respiratory rate, systolic blood pressure, temperature and level of consciousness. Nursing Guide Application (NGA): According to the follow-up carried out in this study: If the patient's MEWSS is 4 or below, a ten-minute follow-up was performed. If the MEWSS is five, then five-minute follow-up is passed, and if the score has not changed as a result of the follow-ups, five-minute follow-ups are continued. If the score decreased to four or less, ten-minute follow-up was started, if the score increased, five-minute follow-ups were continued, and the emergency team was informed and the patient was evaluated (the emergency team was informed about the study).

Primary Outcome Measures

Name	Time	Method
Effects of MEWSS and NGA use on complications and clinical status	From the first 5 minutes when the patient comes to the post-anesthesia care unit to the end of the second hour	Length of stay in ASBU (minutes), complications developed in ASBU, intervention time to complications (minutes), and where it was transferred after ASBU (clinical or intensive care unit)
Effect of MEWSS and NGA use on nursing interventions	From the first 5 minutes when the patient comes to the post-anesthesia care unit to the end of the second hour	Nursing interventions include practices such as oxygen saturation, blood pressure, pulse, respiration, body temperature, alertness, pain monitoring by nurses, positioning and giving medication.
Effect of MEWSS and NGA use on vital signs and MEWS	From the first 5 minutes when the patient comes to the post-anesthesia care unit to the end of the second hour	Heart rate (beats per minute), respiratory rate (respiratory rate / min.), systolic blood pressure (mmHg), temperature (centigrade degree -°C), level of consciousness (AVPU) and the score obtained from these measurements show MEWS.

Trial Locations

Locations (1)

Kocaeli University Hospital; 🇹🇷 Kocaeli, Turkey