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Measuring and monitoring vital signs
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Measuring and monitoring the six vital signs of respiratory rate (RR), oxygen saturation SpO2 blood pressure (BP), pulse (HR), ACVPU scale (alert, new confusion, voice, pain, and unresponsive) and temperature (T) are essential to health care professionals each day. Collectively they are referred to as vital signs and make up the components of the National Early-Warning Score 2 (NEWS2). All student nurses and nursing associates should learn to measure and record vital signs accurately (Nursing and Midwifery Council [NMC] 2018a, 2018b). Acting upon vital sign measurements in a timely and appropriate manner can contribute to the recognition of deterioration of the individual’s condition and help to gain an understanding of their well-being.
Assessment and recognition of emergencies in acute care
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Initially, there was a lack of standardisation of EWS across the NHS that prevented it from becoming part of routine training for all health care professionals. Variation led to lack of familiarity with different tools and trigger levels, as staff moved between clinical areas and hospital trusts. The development and publication of a validated National Early Warning Score (NEWS) in 2012 (RCP 2012) provided benefits of clarity and consistency. Whilst widely embraced by acute care trusts, NEWS continued to be developed in response to feedback from users and professional bodies. In 2017, a revised edition, NEWS 2, was released, with full adoption in March 2019 (NHS England 2018).
Use of Patient Care Device Data for Clinical Surveillance
Published in John R. Zaleski, Clinical Surveillance, 2020
An example wherein the combination of data from multiple sources results in an integrated assessment of the patient is in the use of early warning scores (EWS) that combine vital signs measurements with observations. Table 2.3 summarizes an example of one early warning score that combines measurements of heart rate, respiration, urine output, and patient conscious awareness.
FlowTriever Retrieval System for the treatment of pulmonary embolism: overview of its safety and efficacy
Published in Expert Review of Medical Devices, 2021
Vivian L. Bishay, Omosalewa Adenikinju, Rachel Todd
The HI-PEITHO trial is a large, multi-center, randomized clinical trial currently enrolling participants to compare AC plus USAD with AC alone for the treatment of acute intermediate-high risk PE. Inclusion criteria will enrich the study population with those at elevated risk of early death or hemodynamic collapse. The primary end point has been defined as a 7-day composite of PE-related mortality, shock, need for ventilation or ECMO, recurrence of a PE, or cardiorespiratory decompensation or collapse. As a safety measure, researchers will use the National Early Warning Score (NEWS) system to track patients’ progress and predict deterioration. A NEWS score of 9 or greater – which is correlated with an increased risk of cardiac arrest, death and ICU admission within 24 hours – will trigger the primary endpoint, at which point the patient’s treatment will be managed at the investigator’s discretion. Patients will also receive long-term follow-up up to one year. The trial has been designed to provide the first Level 1 data for ultrasound-facilitated catheter-directed thrombolysis for PE. It is expected to run until the end of 2024.
Moderating Role of Attachment Orientation in the Association between the Level of Depressive Symptoms and Informal Support among Hospitalized Older Adults
Published in Clinical Gerontologist, 2021
Nurit Gur-Yaish, Ksenya Shulyaev, Anna Zisberg
Functional status before hospitalization was assessed using the Barthel Index for Activities of Daily Living (ADL) (Mahoney & Barthel, 1965) and the Lawton’s Instrumental Activities of Daily Living (IADLs) (Lawton & Brody, 1969). Higher scores in both instruments indicate higher levels of independence. Cognitive status was measured using Pfeiffer’s Short Portable Mental Status Questionnaire (SPMSQ) (Pfeiffer, 1975). Total scores ranged from 0 to 10, with higher scores indicating higher cognitive status. Chronic morbidity was assessed using Charlson’s Comorbidity Index (CCI) (Charlson, Pompei, Ales, & MacKenzie, 1987), an index weighting the number and severity of health conditions among patients. The index relies on information from patients’ medical files assessing 20 health conditions, with each carrying a weighted score ranging from 1 to 6. Severity of illness was assessed with the National Early Warning Score (NEWS) (Williams et al., 2012) a well-validated, track-and-trigger, early warning score system that is used to identify and respond to patients at risk of deteriorating. It is based on a simple scoring system in which a score is given to physiological measurements already being monitored when patients are in health care settings. A summary score ranges from 0 (low risk) to 20 (high risk). Background characteristics included age, gender, years of education, family status, and number of children. We also controlled for participation in Walk-FOR intervention.
Outpatient endometrial ablation: audit of outcomes and patient satisfaction
Published in Journal of Obstetrics and Gynaecology, 2020
One hundred and fifty-one outpatient endometrial ablation procedures were performed between March 2015 and July 2017. In the women’s health treatment clinic, there is a team of consultant, senior nurse and healthcare assistant. Patient’s early warning score is checked prior to the procedure. Patient’s partner is allowed and encouraged to sit with her. The nurse and healthcare assistant chat with the patient to distract her and a comfortable environment is provided. One hundred and three cases were performed as day-case procedures under general anaesthesia in the same time period mainly due to patient choice and inability to tolerate pain. Data were entered on Microsoft excel sheet by the operating consultant including pre-procedure hysteroscopy, whether procedure completed and reason if abandoned as well as pain score on a scale of 1–10 intraoperative and immediate post-procedure. Post-op hysteroscopy was performed to check integrity of the cavity and adequacy of treatment. Data were analysed on Microsoft excel.