Skip to main content

Table 6 Numbers of patients with recordings and nurses’ responses to recordings that should have and did, or did not, trigger a response a in the first eight postoperative hours (per protocol analysis)

From: Early warning scoring systems versus standard observations charts for wards in South Africa: a cluster randomized controlled trial

 

Intervention arm

Control arm

   

Parameter

MEWS chart n = 36 patients

 

Existing chart n = 57 patients

 

Pvalue

OR (df = 1)

95% CI

 

Number (%)

Response triggered

Number (%)

Response triggered

 

Respiratory rate recorded

25 (69.4)

 

2 (3.5)

 

<0.001

62.50

12.89-303.15

Respiratory rate should have triggered a response

20 (55.6)

0

0

0

1.00

  

Heart rate recorded

36 (100)

 

57 (100)

 

1.00

  

Heart rate should have triggered a response

12 (33.3)

0

19 (33.3)

0

1.00

  

Oxygen saturation recorded

6 (16.7)

 

2 (3.5)

 

0.03

5.5

1.05-28.95

Oxygen saturation should have triggered a response

1 (2.8)

0

1 (1.8)

0

1.00

  

Systolic blood pressure recorded

36 (100)

 

57 (100)

 

1.00

  

Systolic blood pressure should have triggered a response

15 (41.7)

3 (20.0)

25 (43.9)

1 (4.0)

0.23

5

0.48-52.53

Temperature recorded

35 (97.2)

 

54 (94.7)

 

1.00

1.94

0.19-19.45

Temperature should have triggered a response

17 (47.2)

0

22 (38.6)

0

1.00

  

Level of consciousness recorded

33 (91.7)

 

37 (64.9)

 

0.004

5.95

1.62-21.84

Level of consciousness should have triggered a response

6 (16.7)

0

7 (12.3)

0

1.00

  

Urine output recorded

33 (91.7)

 

51 (89.5)

 

0.12

1.29

0.30-5.54

Urine output should have triggered a responseb

17 (47.2)

0

16 (28.1)

0

1.00

  

All parameters recorded

5 (13.9)

 

0

 

0.003

20.08b

1.08-375.09b

Incomplete recording of all parameters

31 (86.1)

 

57 (100)

  
  1. For 21 patients in the intervention arm, the MEWS chart had not been used.
  2. aMEWS trigger of 1 = recheck measurement after half an hour and report if no improvement; MEWS trigger of 2 = recheck measurement after five minutes and report immediately if no improvement; MEWS trigger of 3 = critical, report urgently.
  3. bHaldane’s estimator was used for calculating OR (this circumvents zero values in cells by adding one half to each cell).
  4. In the intervention wards nurses responded to 3.4% (three out of 88) MEWS that should have triggered reporting versus 1.1% (one out of 90) in the control wards (chi-squared = 1.07, df = 1, P = 0.30). Overall, nurses in both arms reported a combined total of four out of 178 (2.2%) deranged physiological parameters for four out of 93 (4.3%) patients who needed to be assessed (three in the intervention arm, and one in the control arm). CI, confidence interval; MEWS, modified early warning score; OR, odds ratio; df, the degrees of freedom, or the number of ‘entities’ that are free to vary when a statistical test is applied; this also determines the probability distribution used for the test statistic (see footnote to Table 3).