Knowledge, Attitudes and Practice of Nurses in Assessing Patients using Early Warning Sign (EWS) Scoring in a teaching hospital in Kuantan Pahang, Malaysia

Abstract

Introduction: Early Warning Sign (EWS) is a tool made up of vital signs chart and scoring to detect any changes in patient so that immediate and appropriate care can be further determined and provided. The objectives of the study are to assess the level of knowledge, attitudes, and practice of nurses in assessing patient using EWS scoring and to identify association between socio-demographic with knowledge, attitudes, and practice, as well as to determine the associations between knowledge with attitudes, attitudes with practice and knowledge of nurses in assessing patient using EWS scoring. Methods: A quantitative cross- sectional study with convenience sampling study was conducted on 132 nurses from medical, surgical and orthopedics wards in Sultan Ahmad Shah Medical Centre (SASMEC) from November 2020 until January 2021. Printed questionnaires were distributed to the nurses in English language. The questionnaire consisted of two parts. Part A was about socio-demographic data (area and on years of nursing practice, & service, area of practice, educational level, as well as whether holding post-basic/ advance course certificate, attending life support training and ICU outreach participant). Part B was about knowledge, attitudes, and practices of EWS. Data analysis was interpreted in descriptive and inferential analysis using Statistical Package for the Social Sciences (SPSS) version 20.0. Results: A total of 108 respondents involved in the study represents 82% response rate. Majority of respondents scored low in knowledge questions with grade F (n=106, 98.3%). One respondent scored grade D, correctly answering 8 over 13 questions (62%). Only one respondent obtained grade B with 85% score. Based on the result, there are more participants (n=58, 53.7%) achieving good attitudes while respondents with poor attitudes were (n=50, 46.3%). Moreover, 59 respondents (54.6%) have higher practice level than mean score, indicating good EWS practice. The remaining 49 respondents (45.4%) scored below the mean score cut off point indicating poor practice. The mean values are different depending on working areas in terms of attitudes and practice. The association between attitudes and practice (r= 0.641, p-value<0.01) is confirmed having a positive and strong correlation. Conclusion: The study revealed that despite having poor knowledge on EWS, the nurses have demonstrated good attitudes and practice in detecting patients’ progressive deteriorating conditions; thus, confirming that there are associations in area of practice with attitudes and practice. The results also shows that there is a significant difference between attitudes and practice of nurses in assessing patient using EWS with (p- value< 0.05).

Thay Đổi Kiến Thức Của Điều Dưỡng Về Thang Điểm Cảnh Báo Sớm

“…Một số nghiên cứu báo cáo kết quả kiến thức của điều dưỡng về EWS ở mức tốt thường dưới 60%. 2,3,4 Kiến thức về EWS của điều dưỡng bị ảnh hưởng bởi một số yếu tố bao gồm tuổi, giới, thâm niên công tác và trình độ học vấn. 3,5 Kiến thức và năng lực của các nhân viên chăm sóc sức khỏe được cải thiện ngay lập tức sau các chương trình giáo dục khác nhau.…”

“…Tỷ lệ này tương đồng so với các nghiên cứu khác khi điều dưỡng trẻ là lực lượng chính tại các khoa cấp cứu. 3,4,5 Kết quả của nghiên cứu này cho thấy trước khi đào tạo, đa số điều dưỡng có mức độ kiến thức ở mức trung bình và kém (56,7% và 23,3%). Kiến thức của điều dưỡng về EWS được cải thiện ngay sau khi có các chương trình đào tạo.…”

Evaluating Effectiveness of MEOWS Tool in Identifying Maternal Deterioration in Women Receiving Care among Nurses in Maternity Unit, at General Hospital, Dammam

“…Six items to assess the nurse's attitude and three items of skills to examine were self-perceived competence, in which they needed to rate themselves with 'YES' (score 2) and 'NO' (score 1). The questionnaire items were adopted and modified from Nair, Dockrell & Colgain (2018) and Donilon (2013) in Alias & Ludin (2021). The questionnaire for this study has also been proven valid and reliable (Cronbach alpha = 0.75; r > 0.40).…”

“…The score was created in the late 1990s. Studies at the time showed that in-hospital cardiac arrest and deterioration were often followed by a period of increasing abnormalities in vital signs (Alias & Mohamed Ludin, 2021). Moreover, failure to recognize early detection signs and respond to the patient's condition in a timely manner can lead to the death of the patient.…”