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Nurses' perception on initial implementation of early warning system: a mixed method study


Sujalmo, P and Setiyarini, S and Walsh, K and Greenwood, M, Nurses' perception on initial implementation of early warning system: a mixed method study, Jurnal Keperawatan Soedirman, 17, (1) pp. 29-35. ISSN 1907-6673 (2022) [Refereed Article]


Copyright Statement

Copyright 2022 The Authors Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

DOI: doi:10.20884/1.jks.2022.17.1.4927


The early warning system (EWS) has been decided as a new standard for Indonesian hospitals. The main objective of EWS implementation is to help nurses quickly recognize and react to deteriorating patients. This study explores how EWS contributes to nurses' clinical decisions around patient deterioration. The research design for this study was mixed-method sequential explanatory. A purposive sampling approach was used to recruit the participants. Closed and open-ended questionnaires were distributed (n = 53) to adult unit nurses and the data was analyzed by using descriptive statistics. Focus group discussions were conducted to evaluate the implementation process and the results obtained were analyzed by using thematic analysis. Both data were integrated by using a joint display table. We found that 79% of nurses indicated that they needed education about how to use the EWS and 92% of nurses required education on physiology and management of the deteriorating patient. Three themes emerged: (1) the nurses' experience of EWS Implementation, (2) the impact of EWS implementation, and (3) ameliorating the EWS Implementation. The participants showed that the EWS has been used for the assessment, documentation, and communication process of deteriorating patient management. The EWS is a complex tool for nurses, and they need support from stakeholders to maintain and optimize the advantages.

Item Details

Item Type:Refereed Article
Keywords:medical emergency, rapid response systems, nursing
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Health systems
Objective Division:Health
Objective Group:Clinical health
Objective Field:Diagnosis of human diseases and conditions
UTAS Author:Walsh, K (Professor Kenneth Walsh)
UTAS Author:Greenwood, M (Associate Professor Melanie Greenwood)
ID Code:150041
Year Published:2022
Deposited By:Nursing
Deposited On:2022-05-14
Last Modified:2022-10-17
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