Evaluation of the Modified Early Warning Scoring System

October 6, 2023 updated by: SELDA MERT, Kocaeli University

The Effect of Modified Early Warning Scoring System and Nursing Guide Practices on Postoperative Patient Outcomes

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.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

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 Type

Interventional

Enrollment (Actual)

220

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
      • Kocaeli, Turkey
        • Kocaeli University Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Description

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 Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental Group

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).
Other: MEWSS and Nursing Guide Application
MEWSS and Nursing Guide application will be used for the patients in the experimental group. According to the Nursing Guide application, patients with MEWS above 4 will be monitored every 5 minutes, while those with a score below 4 will be monitored for 10 minutes. will be followed intermittently. Nursing interventions will be made in accordance with the problems experienced by patients with a score above 4.
No Intervention: Control Group
In the control group, the patients followed according to the Modified Early Warning Scoring System received routine care in the clinic.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Effects of MEWSS and NGA use on complications and clinical status
Time Frame: 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)
From the first 5 minutes when the patient comes to the post-anesthesia care unit to the end of the second hour
Effect of MEWSS and NGA use on vital signs and MEWS
Time Frame: 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.
From the first 5 minutes when the patient comes to the post-anesthesia care unit to the end of the second hour
Effect of MEWSS and NGA use on nursing interventions
Time Frame: 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.
From the first 5 minutes when the patient comes to the post-anesthesia care unit to the end of the second hour

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Kocaeli University

Investigators

  • Principal Investigator: Selda MERT, Assist.Dr., Kocaeli University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 29, 2022

Primary Completion (Actual)

October 31, 2022

Study Completion (Actual)

January 12, 2023

Study Registration Dates

First Submitted

October 6, 2022

First Submitted That Met QC Criteria

October 8, 2022

First Posted (Actual)

October 12, 2022

Study Record Updates

Last Update Posted (Estimated)

October 9, 2023

Last Update Submitted That Met QC Criteria

October 6, 2023

Last Verified

March 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • KAEK/17.bI.02

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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