Analisis Faktor Risiko Ketidakpatuhan Penerapan Early Warning Score Terhadap Mortalitas Pasien
DOI:
https://doi.org/10.30643/jiksht.v17i2.188Keywords:
Non-Compliance, EWS, MortalityAbstract
Early Warning Score (EWS) is tool that could be applicated to know the early deterioration of the patient. There are seven criteria/indicator in the EWS, these are temperature, O2 saturation, heart rate, O2 supplement, systolic blood pressure, respiratory rate, consciousness. The ability to know the worsening condition in these seven indicators will help the medical team to give prompt treatment to the patients. Wates General Hospital is one of the hospitals in Indonesia that has carry out the EWS system. There is no research conducted on Early Warning Scores in that hospital. The objective to look at the risk of non-compliance with the implementation of EWS on the patient's mortality rate and to see other risk factors for patient mortality. This is an analytic observational study with a case-control retrospective design. Calculation of samples in the case and control groups with purposive sampling method with a total sample of 328 consisting of 82 cases (mortality) and 246 control groups (no mortality patients). Data analysis bivariate data is analized with statictic chi square test and logistic regression. Results The risk for non-compliance to EWS implementation is significantly affect the patient mortality with p-value score of 0,001 (p<0.05). Other risk factors that significantly affect the patient’s mortality are patient severity level, heart disease, stroke, pneumonia, and sepsis. Compliance with the EWS protocol is statistically significant correlation with patient mortality. Implementing good EWS will help medical tim to know early the patient's condition. patient mortality is significantly affected by non-compliance with EWS implementation.
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Alam, N., Hobbelink, E. L., Tienhoven, A. J. Van, Ven, P. M. Van De, Jansma, E. P., & Nanayakkara, P. W. B. (2014). The impact of the use of the Early Warning Score ( EWS ) on patient outcomes : A systematic review . Resuscitation, 85(5), 587–594. https://doi.org/10.1016/j.resuscitation.2014.01.013
Bressman, E., Rowland, J. C., Nguyen, V., & Raucher, B. G. (2020). Severity of illness and the weekend mortality effect : a retrospective cohort study. BMC Health Services Research, 6 (1), 1–7, https://doi.org/10.1186/s12913-020-5029-6
Credland, N., Dyson, J., & Johnson, M. J. (2018). What are the patterns of compliance with Early Warning Track and Trigger Tools : A narrative review. Applied Nursing Research, 44(9), 39–47. https://doi.org/10.1016/j.apnr.2018.09.002
Day, T., & Oxton, J. (2014). The National Early Warning Score in practice: a reflection. British Journal of Nursing, 23(19), 1036- 40. https://doi. 10.12968/bjon.2014.23.19.1036
Friman, O., Bell, M., Djärv, T., Hvarfner, A., & Jäderling, G. (2018). National Early Warning Score vs Rapid Response Team criteria — Prevalence , misclassification , and outcome. Acta Anaesthesiologica Scandinavica, 00, 1–7. Https://doi.org/10.1111/aas.13245
Gattringer, T., Posekany, A., Niederkorn, K., Knoflach, M., Poltrum, B., Mutzenbach, S., … Kiechl, S. (2018). Predicting Early Mortality of Acute Ischemic Stroke. AHA Journals, 00, 1-8. https://doi.org/10.1161/STROKEAHA.118.022863
Gebreyohannes, E. A., Bhagavathula, A. S., Abebe, T. B., Seid, M. A., & Haile, K. T. (2019). In-Hospital Mortality among Ischemic Stroke Patients in Gondar University Hospital : A Retrospective Cohort Study. Stroke Research and Treatment, 2019 (0), 1-7. https://doi.org/10.1155/2019/7275063
Haegdorens, F., Monsieurs, K. G., Rn, K. D. M., & Rn, P. V. B. (2019). An intervention including the national early warning score improves patient monitoring practice and reduces mortality : A cluster randomized controlled trial. Journal of Advanced Nursing, 2019 (75), 1996-2005. https://doi.org/10.1111/jan.14034
Hajj, J., & Blaine, N. (2018). The “ Centrality of Sepsis â€: A Review on Incidence , Mortality , and Cost of Care. healthcare, 6 (3), 1–11. https://doi.org/10.3390/healthcare6030090
Hammond, N. E., Bn, A. J. S., Dip, G., Barnett, A. G., Bn, A. C., Cert, G., … Mb, J. F. F. (2013). Australian Critical Care The effect of implementing a modified early warning scoring ( MEWS ) system on the adequacy of vital sign documentation. Australian Critical Care, 26(1), 18–22. https://doi.org/10.1016/j.aucc.2012.05.001
Hands, C., Reid, E., Meredith, P., Smith, G. B., Prytherch, D. R., Schmidt, P. E., & Featherstone, P. I. (2013). Patterns in the recording of vital signs and early warning scores : compliance with a clinical escalation protocol. BMJ Quality & Safety, 22 (9), 719–726. https://doi.org/10.1136/bmjqs-2013-001954
Hayward, R. A. (2015). Due to Medical Errors Preventability Is in the Eye of the Reviewer. JAMA The Journal of the American Medical Association, 286(4), 415–420. https://doi.org/ 10.1001/jama.286.4.415
Liljehult, J., Early, C. T., & Score, W. (2016). Early warning score predicts acute mortality in stroke patients, Acta Neurologica Scandinavica, 133 (3), 261–267. https://doi.org/10.1111/ane.12452
Mathews, C. B., & Shah, S. (2019). Clinical Predictors of Pneumonia Among Children With Wheezing. Pediatrics, 124(1), e29-e36. https://doi.org/10.1542/peds.2008-2062
Patel, M. S., Jones, M. A., Jiggins, M., & Williams, S. C. (2011). Does the use of a ‘“ track and trigger â€â€™ warning system reduce mortality in trauma patients ?. Injury, 42 (12), 1455–1459. https://doi.org/10.1016/j.injury.2011.05.030
Royal College of Physicians. (2017). National Early Warning Score National Early Warning Score ( NEWS ). London: Copyright of Royal College of Physicians.
Scott, F. D., Gamble, D. david, & Welch, M. J. (2017). Impact of implementation of the National Early Warning Score on patients and staff. British Journal of Hospital Medicine, 78(3), 132–136. https://doi.org/ 10.12968/hmed.2017.78.3.132
Seok, Y., Woo, J., Hee, Y., Chung, C., Il, D., Eun, J., Young, J. (2018). Evaluation of the ef fi cacy of the National Early Warning Score in predicting in-hospital mortality via the risk strati fi cation ☆. Journal of Critical Care, 47, 222–226. https://doi.org/10.1016/j.jcrc.2018.07.011
Singh, M., Peterson, E. D., Roe, M. T., Ou, F., Spertus, J. A., Rumsfeld, J. S., … Holmes, D. R. (2009). Trends in the Association Between Age and In-Hospital National Cardiovascular Data Registry Experience. Circulation: Cardiovascular Interventions,2(1),20–26. https://doi.org/10.1161 /CIRCINTERVENTIONS. 108.826172
Smith, M. E. B., Chiovaro, J. C., Neil, M. O., Kansagara, D., Quiñones, A. R., Freeman, M., … Slatore, C. G. (2014). Early Warning System Scores for Clinical Deterioration in Hospitalized Patients : A Systematic Review. Annals of the American Thoracic Society, 11(9), 1454–1465. https://doi.org/10.1513/AnnalsATS.201403-102OC
Zhang, Z. X., Yong, Y., Tan, W. C., Shen, L., & Ng, H. S. (2018). Prognostic factors for mortality due to pneumonia among adults from different age groups in Singapore and mortality predictions based on PSI and CURB-65. Singapore Medical Journal, 59(4), 190–198. https://doi.org/10.11622/smedj.2017079
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