We develop an interesting set of skills as nurses. We have that 6th “early warning sense” … intuition, if you will … when something just isn’t right with a patient. Patient deterioration is often difficult to assess because of the complex nature of patient care and the need for accurate assessment skills. I had a septuagenarian nursing instructor who said we were never allowed to tell a doctor “there’s something wrong with the patient.” We had to describe the signs and symptoms that made us believe the patient was in trouble. This invaluable lesson created stronger relationships between the nurses and doctors, while being beneficial to the patients.
As nurses we use all our senses and our powers of observation to help us care for patients. But to do this, it requires us to be in the room with the patient. We see the color changes on a patient’s skin. We hear what they’re saying to us and their breathing patterns. We can smell the various scents of a patient’s condition as soon as we enter the room. Our sense of touch can detect a patient with a fever before taking their temperature. I won’t cover the sense of taste here… except to say we greatly appreciate the treats families bring into us.
The point is, the more time nurses spend monitoring patients, the more tuned into their condition we become. Patients frequently show physical signs of deterioration several hours before a critical event, requiring some type of rigorous intervention. Early analysis of these signs, followed by prompt action reduces adverse events.
To identify patients at risk more reliably, hospitals are using an Early Warning Scoring System (EWSS) based on key physiologic measures. Device connectivity to the EMR can help us spend less time charting and more time with the patient, giving us better data to diagnose issues sooner to improve the quality and efficiency of the care we give. Wouldn’t it be helpful to have your “early warning 6th sense” validated by matching and trending patient vital signs to early warning scores?
Is your hospital using any type of Early Warning Scoring to monitor and detect patient status? What have your results been?