Skip to main content

Advertisement

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).