Purpose To evaluate the effect of national early warning scoring system (NEWS) implementation in identifying patients at risk of clinical deterioration at an emergency hospital. Background Early warning score has been developed to facilitate early detection of deterioration by categorizing a patients’ severity of illness and prompting nursing staff to request a medical review at specific trigger points. Patients and Methods A prospective, control/intervention groups’, quasi-experimental design was utilized. A sample of 364 adult patients were admitted to the inpatient unit at an emergency hospital for six months. The patients were divided into a study group (174 patients) and a control group (190 patients). All study patients were followed up to either death or hospital discharge before and after implementing a new observation chart. The patients’ outcomes were compared and analyzed between both groups. Results In the intervention period, compared to the control period, a significant reduction was seen in the number of cardiopulmonary arrest (4.7% vs 1.1%, p = 0.046), unplanned ICU admission (5.3% vs 1.7%, p = 0.049), emergency surgery (6.3% vs 0%, p = 0.001), acute kidney injury (6.8% vs 1.1%, p = 0.006). As well, there was a significant increase in the number of patients receiving medical reviews following clinical deterioration in terms of escalation plan (3.2% vs 26.4%, p = <0.001). Conclusion The implementation of NEWS was associated with a significant improvement in patients’ outcomes in hospital wards, increases in the frequency of vital signs measurements, and an increase in the number of medical reviews following clinical instability.

Background: The use of oral hygiene approaches is vital for maintaining the health and comfort of patients. This is especially true for those in intensive care who are intubated and on mechanical ventilation because proper oral hygiene practices greatly reduce the possibility of complications and shorten hospital stays for such patients. Aim: The aim of this study is to evaluate the effect of oral care protocol on oral health status among mechanically ventilated patients. Research Design: A quasi-experimental study with one group pre-test and post-test design was utilized for the current study. Setting: The study was carried out in the intensive care unit at Cairo university hospital. Sample: A purposive sample of (30) male and female patients admitted to the ICU and a convenience sample of (15) nurses were included in the current study. Tools of data collection: Four tools were utilized to collect data pertinent to the current study: tool (1) patient's demographic and medical data sheet, tool (2) nurses' demographic characteristics sheet, tool (3 )Beck oral assessment score (BOAS) modified, tool (4) observational checklist for nurses' practice. Results: There is a significant decrease in total mean oral health score post intervention in the 3 days which indicates less dysfunction post intervention. The majority (86.7%) of the studied nurses had a satisfactory level of practice related to oral care for mechanically ventilated patients. Conclusion:The oral health status of mechanically ventilated patients improved after the intervention of oral care. Recommendations: Applying oral care for mechanically ventilated patients, the oral health condition of intubated patients should be frequently assessed by nurses in the ICU utilizing oral assessment tools as a basis for intervention.

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Aims and Objectives:To determine the effect of a designed program about the National Early Warning Score on nurses' knowledge at an emergency hospital. Background: The Early Warning Score has been developed as a tool for early detection of patients' deterioration. However, its implementation has not been optimal due to the lack of knowledge and understanding of EWS among staff nurses. Design: Pre-test/posttest quasi-experimental research design. Methods: A convenient sample of 34 nursing staff working at the inpatient unit at an emergency hospital was included in the education program. Results: The current findings revealed that all nurses (100 %) (34) had an unsatisfactory knowledge level pre-educational program. While nurses' knowledge level post-educational program showed, most of them (97.1 %) (33) had a satisfactory knowledge level. And there was a highly significant statistical difference between pre-test and post-test of knowledge (p <0.001). Moreover, nearly half of the nurses (50.2 %) answered knowledge questions incorrectly pre-educational program, while post-educational program, the majority of them (91.6%) answered knowledge questions correctly. Conclusion: After implementing an educational program regarding National Early Warning Score, The emergency care nurses' knowledge was markedly improved.