Implementation of a MEWS-Sepsis screening tool: Transformational outcomes of a nurse-led evidence-based practice project

Nurs Forum. 2020 Apr;55(2):144-148. doi: 10.1111/nuf.12408. Epub 2019 Nov 8.

Abstract

Background: One in three patients who die in the hospital has sepsis. Alerting clinicians to early detection of high-risk patients before deterioration is a top health care priority. Modified Early Warning Scoring (MEWS) tools have assisted organizations in identifying at-risk patients at the first sign of subtle deterioration.

Aim and setting: In conjunction with an academic-clinical partner, we evaluated, revised and implemented a modified MEWS-Sepsis screening tool in an acute care facility.

Participants: One hundred and thirty-nine direct-care nurses participated in tool evaluation.

Methods: Using a plan-do-study-act cycle of quality improvement, critical care scenarios from septic patient data were created and tested in a simulated setting.

Results: Upon implementation of the MEWS-Sepsis tool, the monthly risk-adjusted sepsis mortality rate immediately declined by 24%. The decline in mortality has been sustained from implementation to the present, spanning a 5-year period.

Conclusions: The implementation of a MEWS-Sepsis screening tool contributed to early identification and implementation of time-sensitive interventions aimed at preventing sepsis-associated deaths. MEWS-Sepsis tools hold potential for scale-up and spreading out of evidence-based practice nursing innovations to transform care, improve patient outcomes, and save lives.

Keywords: academic/service partnerships; critical care; evidence-based; quality improvement.

MeSH terms

  • Adult
  • Evidence-Based Nursing / methods
  • Evidence-Based Nursing / trends
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Mass Screening / methods*
  • Mass Screening / trends
  • Middle Aged
  • Nursing Research
  • Sepsis / classification*
  • Sepsis / diagnosis
  • Sepsis / physiopathology
  • Severity of Illness Index