Preventing unrecognized deterioration & improving outcomes of critically ill patients using the National Early Warning Score 2 in a high dependency unit in Bangladesh: A quality improvement project

Author:

Anam Ahmad Mursel1ORCID,Shareef Adnan2,Shumy Farzana3,Gerardus King Matthew Roderick4

Affiliation:

1. Associate Consultant, Critical Care & Internal Medicine, Square Hospitals Ltd, Dhaka, Bangladesh

2. Senior House Officer, HDU, Square Hospitals Ltd, Dhaka, Bangladesh

3. Associate Consultant, Rheumatology & Internal Medicine, Square Hospitals Ltd, Dhaka, Bangladesh

4. Consultant, Acute & GIM, Western General Hospital, Edinburgh, UK

Abstract

This Quality Improvement Project (QIP) aimed to assess the acceptability and utility of the National Early Warning Score 2 (NEWS2) in a Bangladeshi level-2 care setting. All nurses and physicians were trained on NEWS2 scores and a proper response before starting the QIP. Utilization of NEWS2 and patient outcome were documented and analyzed. Acceptability was acknowledged by increase in utilization, and utility by reduction in unrecognized deterioration of patients. The modified NEWS2 was well adopted and utilized by the nursing staff. There was a statistically significant reduction in unrecognized deterioration leading to cardiac arrest and the need for transfer to the Intensive Care Unit after implementation of NEWS2. With adequate training, motivation and appropriate modification, NEWS2 can become a well-accepted, widely adopted and realistic bedside monitoring tool in resource-limited settings like Bangladesh.

Publisher

SAGE Publications

Subject

Infectious Diseases,Public Health, Environmental and Occupational Health

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