Using the MEWS to Identify Patients in Distress

BY DAVID BOYD, RN
VICE-PRESIDENT/CHIEF NURSING INFORMATICS OFFICER

Community Medical Centers has started a pilot of the Modified Early Warning Score (MEWS). MEWS is a simple, statistically valid and reliable scoring system that makes use of routinely-recorded physiological parameters to identify patients likely to deteriorate and guide nurses and care team members to appropriate actions – including activating  the rapid response/acute changes team (RRT/ACT) and/or notifying physicians. This tool is used in multiple hospitals in the United States, Australia, and the United Kingdom. Use of MEWS in conjunction with response teams has been associated with significant reductions in both cardiac arrests and unplanned transfers to the ICU.
 
MEWS triggers nursing supervisors to identify patients with high or rising scores, allowing focus on the most acute patients. Vital Sign accuracy and follow up has improved. On a few occasions, a call to the doctor and receipt of orders for changed parameters, has stabilized the patient and likely decreased the need for an ACT mobilization.
 
 
Based upon numerical changes in the MEWS score, here are our corresponding nursing response guidelines:
 
 
To facilitate your review when notified by nursing regarding changes in a MEWS score, you can access the patient’s MEWS Score Trend Report in the Patient Summary activity in Epic.