Effects of Modified Early Warning Score on the Level of Sepsis Progression and Mortality among Hospitalized Medical Patients

Abstract

Early recognition of sepsis is very important because it may results in better patient outcomes. It is very critical for nurses to recognize early signs of sepsis and to take appropriate action to prevent the progression of sepsis.

To examine the effects of the implementation of a modified early warning scores on the level of sepsis progression and mortality among hospitalized medical patients.

This study was a quasi-experimental study. The before implementation was between November 2014 and March 2015, while the after implementation was from April to November 2015. Data were collected in 72 patients who admitted at the medical unit, Maharaj Nakorn Chiang Mai Hospital. This study was conducted under approval from the Institutional Review Board of the Faculty of Medicine, Chiang Mai University. Data entry and analysis were performed using the software package SPSS, version 22.

1. There was a strong association between period (i.e., before and after implementing modified early warning scores) and the level of sepsis progression (i.e., sepsis, severe sepsis, septic shock, and no infection) among hospitalized medical patients (x2 = 38.63, p < 0.001). Before implementing modified early warning scores, 26 patients ended up with septic shock (72.22 percent) while three patients had septic shock (8.33 percent) after modified early warning scores was implemented. 2. According to the mortality, the relationship between period of implementing modified early warning scores and status before discharge from the unit (i.e., discharge, refused for further treatment, transfer to Intensive Care Unit (ICU), transfer to sub-ICU, and dead) was statistically significant (x2 = 45.45, p < 0.001). After implementation of modified early warning scores, the mortality went from 17 cases (47.22 percent) to zero.

The implementation of modified early warning scores provides great outcomes among hospitalized medical patients. Since modified early warning scores uses only vital signs and requires no additional equipment or manpower, understanding and implementing modified early warning scores and providing care based on patient's modified early warning scores are critical to health care providers for better patient outcomes.