ingest cdrApp 2017-07-06T12:49:00.802Z ccd64451-f0fc-4a42-94ad-226f4041fa4f modifyDatastreamByValue RELS-EXT cdrApp 2017-07-06T13:17:25.682Z Setting exclusive relation modifyDatastreamByValue RELS-EXT fedoraAdmin 2017-07-06T13:43:12.210Z Setting exclusive relation modifyDatastreamByValue RELS-EXT fedoraAdmin 2017-07-06T13:43:20.367Z Setting exclusive relation modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-01-05T12:16:50.822Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-01-25T08:52:28.472Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-01-27T09:09:32.069Z modifyDatastreamByValue RELS-EXT fedoraAdmin 2018-02-25T21:03:45.475Z Setting exclusive relation addDatastream MD_TECHNICAL fedoraAdmin 2018-02-25T21:03:56.565Z Adding technical metadata derived by FITS addDatastream MD_FULL_TEXT fedoraAdmin 2018-02-25T21:04:22.490Z Adding full text metadata extracted by Apache Tika modifyDatastreamByValue RELS-EXT fedoraAdmin 2018-02-25T21:04:44.368Z Setting exclusive relation modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-03-14T05:49:44.144Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-05-17T17:20:17.259Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-07-11T04:13:31.299Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-07-18T00:30:04.084Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-08-16T13:37:03.074Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-09-21T20:53:55.042Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-09-27T00:15:29.089Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-10-12T00:49:02.789Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2019-03-20T18:50:30.497Z Cameron Phillips Author School of Nursing EVALUATION OF THE MODIFIED EARLY WARNING SCORE (MEWS) SCREENING TOOL FOR PHYSIOLOGICAL SIGNS OF SEPSIS AND THE BURDEN ON EMERGENCY DEPARTMENT REGISTERED NURSING STAFF ABSTRACT Cameron Scott Phillips: Evaluation of the Modified Early Warning Score (MEWS) Screening Tool for Physiological Signs of Sepsis and the Burden on Emergency Department Registered Nursing Staff (Under the direction of Jean Davison) Sepsis is the leading cause of death in hospitals worldwide and one of the most expensive reasons for hospitalization in the US. The CDC reported that sepsis begins outside of the hospital in approximately 80% of cases, and most septic patients first seek treatment at the emergency department (ED) where prompt recognition could decrease mortality. Screening tools used on inpatient hospital units utilize vital signs and laboratory data, however use is limited in the ED. To promote rapid, cost-effective screening for sepsis, the Modified Early Warning Score (MEWS) was implemented to screen adults for abnormal temperature, heart rate, blood pressure, respiratory rate, subjective decreased urine output and altered mental status. There is a lack of research evaluating the ability of the MEWS or any other tool to screen for physiological signs of sepsis in the ED. A retrospective chart review evaluated the accuracy and reliability of the MEWS screen. Two hundred cases were collected; 100 identified as having a positive MEWS and documented suspicion of infection, and 100 identified as having a negative MEWS and no suspicion of infection. A true positive case definition of having an ICD-10 inpatient discharge diagnosis of sepsis was set prior. The data was evaluated using a 2x2 table for sensitivity, specificity and predictive value. A survey was sent to 125 ED nurses to assess perceptions of the MEWS. Quantitative analysis was performed to estimate the number of manual MEWS’s done over a twelve-hour shift. Results showed 53 true-positive cases, 47 false-positive cases, 6 false-negative cases and 94 true-negative cases. The MEWS tool showed 89.83% sensitivity and 66.67% specificity at identifying physiological signs of sepsis. It showed a positive-predicative-value of 53% and a negative-predictive-value of 94%. False-positive cases were predominately associated with respiratory, skin and urinary infections. ED nurses supported the MEWS, but consensus was mixed on who should be screened and how often. A positive MEWS with clinical suspicion for infection expedites throughput for patients with sepsis, leading to faster evaluation, decreased time to confirmed diagnosis, and timely implementation of lifesaving treatment to improve patient outcomes despite its direct burden on nursing staff. Spring 2017 2017 Nursing eng Thesis University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Jean Davison Thesis advisor Debbie Travers Thesis advisor Brian Seely Thesis advisor text Cameron Phillips Author School of Nursing Evaluation of the Modified Early Warning Score (MEWS) Screening Tool for Physiological Signs of Sepsis and the Burden on Emergency Department Registered Nursing Staff ABSTRACT Cameron Scott Phillips: Evaluation of the Modified Early Warning Score (MEWS) Screening Tool for Physiological Signs of Sepsis and the Burden on Emergency Department Registered Nursing Staff (Under the direction of Jean Davison) Sepsis is the leading cause of death in hospitals worldwide and one of the most expensive reasons for hospitalization in the US. The CDC reported that sepsis begins outside of the hospital in approximately 80% of cases, and most septic patients first seek treatment at the emergency department (ED) where prompt recognition could decrease mortality. Screening tools used on inpatient hospital units utilize vital signs and laboratory data, however use is limited in the ED. To promote rapid, cost-effective screening for sepsis, the Modified Early Warning Score (MEWS) was implemented to screen adults for abnormal temperature, heart rate, blood pressure, respiratory rate, subjective decreased urine output and altered mental status. There is a lack of research evaluating the ability of the MEWS or any other tool to screen for physiological signs of sepsis in the ED. A retrospective chart review evaluated the accuracy and reliability of the MEWS screen. Two hundred cases were collected; 100 identified as having a positive MEWS and documented suspicion of infection, and 100 identified as having a negative MEWS and no suspicion of infection. A true positive case definition of having an ICD-10 inpatient discharge diagnosis of sepsis was set prior. The data was evaluated using a 2x2 table for sensitivity, specificity and predictive value. A survey was sent to 125 ED nurses to assess perceptions of the MEWS. Quantitative analysis was performed to estimate the number of manual MEWS’s done over a twelve-hour shift. Results showed 53 true-positive cases, 47 false-positive cases, 6 false-negative cases and 94 true-negative cases. The MEWS tool showed 89.83% sensitivity and 66.67% specificity at identifying physiological signs of sepsis. It showed a positive-predicative-value of 53% and a negative-predictive-value of 94%. False-positive cases were predominately associated with respiratory, skin and urinary infections. ED nurses supported the MEWS, but consensus was mixed on who should be screened and how often. A positive MEWS with clinical suspicion for infection expedites throughput for patients with sepsis, leading to faster evaluation, decreased time to confirmed diagnosis, and timely implementation of lifesaving treatment to improve patient outcomes despite its direct burden on nursing staff. Spring 2017 2017 Nursing eng Thesis University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Jean Davison Thesis advisor Debbie Travers Thesis advisor Brian Seely Thesis advisor text Cameron Phillips Creator School of Nursing Evaluation of the Modified Early Warning Score (MEWS) Screening Tool for Physiological Signs of Sepsis and the Burden on Emergency Department Registered Nursing Staff Sepsis is the leading cause of death in hospitals worldwide and one of the most expensive reasons for hospitalization in the US. The CDC reported that sepsis begins outside of the hospital in approximately 80% of cases, and most septic patients first seek treatment at the emergency department (ED) where prompt recognition could decrease mortality. Screening tools used on inpatient hospital units utilize vital signs and laboratory data, however use is limited in the ED. To promote rapid, cost-effective screening for sepsis, the Modified Early Warning Score (MEWS) was implemented to screen adults for abnormal temperature, heart rate, blood pressure, respiratory rate, subjective decreased urine output and altered mental status. There is a lack of research evaluating the ability of the MEWS or any other tool to screen for physiological signs of sepsis in the ED. A retrospective chart review evaluated the accuracy and reliability of the MEWS screen. Two hundred cases were collected; 100 identified as having a positive MEWS and documented suspicion of infection, and 100 identified as having a negative MEWS and no suspicion of infection. A true positive case definition of having an ICD-10 inpatient discharge diagnosis of sepsis was set prior. The data was evaluated using a 2x2 table for sensitivity, specificity and predictive value. A survey was sent to 125 ED nurses to assess perceptions of the MEWS. Quantitative analysis was performed to estimate the number of manual MEWS’s done over a twelve-hour shift. Results showed 53 true-positive cases, 47 false-positive cases, 6 false-negative cases and 94 true-negative cases. The MEWS tool showed 89.83% sensitivity and 66.67% specificity at identifying physiological signs of sepsis. It showed a positive-predicative-value of 53% and a negative-predictive-value of 94%. False-positive cases were predominately associated with respiratory, skin and urinary infections. ED nurses supported the MEWS, but consensus was mixed on who should be screened and how often. A positive MEWS with clinical suspicion for infection expedites throughput for patients with sepsis, leading to faster evaluation, decreased time to confirmed diagnosis, and timely implementation of lifesaving treatment to improve patient outcomes despite its direct burden on nursing staff. Spring 2017 2017 Nursing eng Doctor of Nursing Practice Thesis University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Jean Davison Thesis advisor Debbie Travers Thesis advisor Brian Seely Thesis advisor text Cameron Phillips Creator School of Nursing Evaluation of the Modified Early Warning Score (MEWS) Screening Tool for Physiological Signs of Sepsis and the Burden on Emergency Department Registered Nursing Staff Sepsis is the leading cause of death in hospitals worldwide and one of the most expensive reasons for hospitalization in the US. The CDC reported that sepsis begins outside of the hospital in approximately 80% of cases, and most septic patients first seek treatment at the emergency department (ED) where prompt recognition could decrease mortality. Screening tools used on inpatient hospital units utilize vital signs and laboratory data, however use is limited in the ED. To promote rapid, cost-effective screening for sepsis, the Modified Early Warning Score (MEWS) was implemented to screen adults for abnormal temperature, heart rate, blood pressure, respiratory rate, subjective decreased urine output and altered mental status. There is a lack of research evaluating the ability of the MEWS or any other tool to screen for physiological signs of sepsis in the ED. A retrospective chart review evaluated the accuracy and reliability of the MEWS screen. Two hundred cases were collected; 100 identified as having a positive MEWS and documented suspicion of infection, and 100 identified as having a negative MEWS and no suspicion of infection. A true positive case definition of having an ICD-10 inpatient discharge diagnosis of sepsis was set prior. The data was evaluated using a 2x2 table for sensitivity, specificity and predictive value. A survey was sent to 125 ED nurses to assess perceptions of the MEWS. Quantitative analysis was performed to estimate the number of manual MEWS’s done over a twelve-hour shift. Results showed 53 true-positive cases, 47 false-positive cases, 6 false-negative cases and 94 true-negative cases. The MEWS tool showed 89.83% sensitivity and 66.67% specificity at identifying physiological signs of sepsis. It showed a positive-predicative-value of 53% and a negative-predictive-value of 94%. False-positive cases were predominately associated with respiratory, skin and urinary infections. ED nurses supported the MEWS, but consensus was mixed on who should be screened and how often. A positive MEWS with clinical suspicion for infection expedites throughput for patients with sepsis, leading to faster evaluation, decreased time to confirmed diagnosis, and timely implementation of lifesaving treatment to improve patient outcomes despite its direct burden on nursing staff. Spring 2017 2017 Nursing eng Doctor of Nursing Practice Thesis University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Jean Davison Thesis advisor Debbie Travers Thesis advisor Brian Seely Thesis advisor text Cameron Phillips Creator School of Nursing Evaluation of the Modified Early Warning Score (MEWS) Screening Tool for Physiological Signs of Sepsis and the Burden on Emergency Department Registered Nursing Staff Sepsis is the leading cause of death in hospitals worldwide and one of the most expensive reasons for hospitalization in the US. The CDC reported that sepsis begins outside of the hospital in approximately 80% of cases, and most septic patients first seek treatment at the emergency department (ED) where prompt recognition could decrease mortality. Screening tools used on inpatient hospital units utilize vital signs and laboratory data, however use is limited in the ED. To promote rapid, cost-effective screening for sepsis, the Modified Early Warning Score (MEWS) was implemented to screen adults for abnormal temperature, heart rate, blood pressure, respiratory rate, subjective decreased urine output and altered mental status. There is a lack of research evaluating the ability of the MEWS or any other tool to screen for physiological signs of sepsis in the ED. A retrospective chart review evaluated the accuracy and reliability of the MEWS screen. Two hundred cases were collected; 100 identified as having a positive MEWS and documented suspicion of infection, and 100 identified as having a negative MEWS and no suspicion of infection. A true positive case definition of having an ICD-10 inpatient discharge diagnosis of sepsis was set prior. The data was evaluated using a 2x2 table for sensitivity, specificity and predictive value. A survey was sent to 125 ED nurses to assess perceptions of the MEWS. Quantitative analysis was performed to estimate the number of manual MEWS’s done over a twelve-hour shift. Results showed 53 true-positive cases, 47 false-positive cases, 6 false-negative cases and 94 true-negative cases. The MEWS tool showed 89.83% sensitivity and 66.67% specificity at identifying physiological signs of sepsis. It showed a positive-predicative-value of 53% and a negative-predictive-value of 94%. False-positive cases were predominately associated with respiratory, skin and urinary infections. ED nurses supported the MEWS, but consensus was mixed on who should be screened and how often. A positive MEWS with clinical suspicion for infection expedites throughput for patients with sepsis, leading to faster evaluation, decreased time to confirmed diagnosis, and timely implementation of lifesaving treatment to improve patient outcomes despite its direct burden on nursing staff. 2017-05 2017 Nursing eng Doctor of Nursing Practice Masters Thesis University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Jean Davison Thesis advisor Debbie Travers Thesis advisor Brian Seely Thesis advisor text Cameron Phillips Creator School of Nursing Evaluation of the Modified Early Warning Score (MEWS) Screening Tool for Physiological Signs of Sepsis and the Burden on Emergency Department Registered Nursing Staff Sepsis is the leading cause of death in hospitals worldwide and one of the most expensive reasons for hospitalization in the US. The CDC reported that sepsis begins outside of the hospital in approximately 80% of cases, and most septic patients first seek treatment at the emergency department (ED) where prompt recognition could decrease mortality. Screening tools used on inpatient hospital units utilize vital signs and laboratory data, however use is limited in the ED. To promote rapid, cost-effective screening for sepsis, the Modified Early Warning Score (MEWS) was implemented to screen adults for abnormal temperature, heart rate, blood pressure, respiratory rate, subjective decreased urine output and altered mental status. There is a lack of research evaluating the ability of the MEWS or any other tool to screen for physiological signs of sepsis in the ED. A retrospective chart review evaluated the accuracy and reliability of the MEWS screen. Two hundred cases were collected; 100 identified as having a positive MEWS and documented suspicion of infection, and 100 identified as having a negative MEWS and no suspicion of infection. A true positive case definition of having an ICD-10 inpatient discharge diagnosis of sepsis was set prior. The data was evaluated using a 2x2 table for sensitivity, specificity and predictive value. A survey was sent to 125 ED nurses to assess perceptions of the MEWS. Quantitative analysis was performed to estimate the number of manual MEWS’s done over a twelve-hour shift. Results showed 53 true-positive cases, 47 false-positive cases, 6 false-negative cases and 94 true-negative cases. The MEWS tool showed 89.83% sensitivity and 66.67% specificity at identifying physiological signs of sepsis. It showed a positive-predicative-value of 53% and a negative-predictive-value of 94%. False-positive cases were predominately associated with respiratory, skin and urinary infections. ED nurses supported the MEWS, but consensus was mixed on who should be screened and how often. A positive MEWS with clinical suspicion for infection expedites throughput for patients with sepsis, leading to faster evaluation, decreased time to confirmed diagnosis, and timely implementation of lifesaving treatment to improve patient outcomes despite its direct burden on nursing staff. 2017 Nursing eng Doctor of Nursing Practice Masters Thesis University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Jean Davison Thesis advisor Debbie Travers Thesis advisor Brian Seely Thesis advisor text 2017-05 Cameron Phillips Creator School of Nursing Evaluation of the Modified Early Warning Score (MEWS) Screening Tool for Physiological Signs of Sepsis and the Burden on Emergency Department Registered Nursing Staff Sepsis is the leading cause of death in hospitals worldwide and one of the most expensive reasons for hospitalization in the US. The CDC reported that sepsis begins outside of the hospital in approximately 80% of cases, and most septic patients first seek treatment at the emergency department (ED) where prompt recognition could decrease mortality. Screening tools used on inpatient hospital units utilize vital signs and laboratory data, however use is limited in the ED. To promote rapid, cost-effective screening for sepsis, the Modified Early Warning Score (MEWS) was implemented to screen adults for abnormal temperature, heart rate, blood pressure, respiratory rate, subjective decreased urine output and altered mental status. There is a lack of research evaluating the ability of the MEWS or any other tool to screen for physiological signs of sepsis in the ED. A retrospective chart review evaluated the accuracy and reliability of the MEWS screen. Two hundred cases were collected; 100 identified as having a positive MEWS and documented suspicion of infection, and 100 identified as having a negative MEWS and no suspicion of infection. A true positive case definition of having an ICD-10 inpatient discharge diagnosis of sepsis was set prior. The data was evaluated using a 2x2 table for sensitivity, specificity and predictive value. A survey was sent to 125 ED nurses to assess perceptions of the MEWS. Quantitative analysis was performed to estimate the number of manual MEWS’s done over a twelve-hour shift. Results showed 53 true-positive cases, 47 false-positive cases, 6 false-negative cases and 94 true-negative cases. The MEWS tool showed 89.83% sensitivity and 66.67% specificity at identifying physiological signs of sepsis. It showed a positive-predicative-value of 53% and a negative-predictive-value of 94%. False-positive cases were predominately associated with respiratory, skin and urinary infections. ED nurses supported the MEWS, but consensus was mixed on who should be screened and how often. A positive MEWS with clinical suspicion for infection expedites throughput for patients with sepsis, leading to faster evaluation, decreased time to confirmed diagnosis, and timely implementation of lifesaving treatment to improve patient outcomes despite its direct burden on nursing staff. 2017 Nursing eng Doctor of Nursing Practice Masters Thesis University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Jean Davison Thesis advisor Debbie Travers Thesis advisor Brian Seely Thesis advisor text 2017-05 Cameron Phillips Creator School of Nursing Evaluation of the Modified Early Warning Score (MEWS) Screening Tool for Physiological Signs of Sepsis and the Burden on Emergency Department Registered Nursing Staff Sepsis is the leading cause of death in hospitals worldwide and one of the most expensive reasons for hospitalization in the US. The CDC reported that sepsis begins outside of the hospital in approximately 80% of cases, and most septic patients first seek treatment at the emergency department (ED) where prompt recognition could decrease mortality. Screening tools used on inpatient hospital units utilize vital signs and laboratory data, however use is limited in the ED. To promote rapid, cost-effective screening for sepsis, the Modified Early Warning Score (MEWS) was implemented to screen adults for abnormal temperature, heart rate, blood pressure, respiratory rate, subjective decreased urine output and altered mental status. There is a lack of research evaluating the ability of the MEWS or any other tool to screen for physiological signs of sepsis in the ED. A retrospective chart review evaluated the accuracy and reliability of the MEWS screen. Two hundred cases were collected; 100 identified as having a positive MEWS and documented suspicion of infection, and 100 identified as having a negative MEWS and no suspicion of infection. A true positive case definition of having an ICD-10 inpatient discharge diagnosis of sepsis was set prior. The data was evaluated using a 2x2 table for sensitivity, specificity and predictive value. A survey was sent to 125 ED nurses to assess perceptions of the MEWS. Quantitative analysis was performed to estimate the number of manual MEWS’s done over a twelve-hour shift. Results showed 53 true-positive cases, 47 false-positive cases, 6 false-negative cases and 94 true-negative cases. The MEWS tool showed 89.83% sensitivity and 66.67% specificity at identifying physiological signs of sepsis. It showed a positive-predicative-value of 53% and a negative-predictive-value of 94%. False-positive cases were predominately associated with respiratory, skin and urinary infections. ED nurses supported the MEWS, but consensus was mixed on who should be screened and how often. A positive MEWS with clinical suspicion for infection expedites throughput for patients with sepsis, leading to faster evaluation, decreased time to confirmed diagnosis, and timely implementation of lifesaving treatment to improve patient outcomes despite its direct burden on nursing staff. 2017 Nursing eng Doctor of Nursing Practice Masters Thesis University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Jean Davison Thesis advisor Debbie Travers Thesis advisor Brian Seely Thesis advisor text 2017-05 Cameron Phillips Creator School of Nursing Evaluation of the Modified Early Warning Score (MEWS) Screening Tool for Physiological Signs of Sepsis and the Burden on Emergency Department Registered Nursing Staff Sepsis is the leading cause of death in hospitals worldwide and one of the most expensive reasons for hospitalization in the US. The CDC reported that sepsis begins outside of the hospital in approximately 80% of cases, and most septic patients first seek treatment at the emergency department (ED) where prompt recognition could decrease mortality. Screening tools used on inpatient hospital units utilize vital signs and laboratory data, however use is limited in the ED. To promote rapid, cost-effective screening for sepsis, the Modified Early Warning Score (MEWS) was implemented to screen adults for abnormal temperature, heart rate, blood pressure, respiratory rate, subjective decreased urine output and altered mental status. There is a lack of research evaluating the ability of the MEWS or any other tool to screen for physiological signs of sepsis in the ED. A retrospective chart review evaluated the accuracy and reliability of the MEWS screen. Two hundred cases were collected; 100 identified as having a positive MEWS and documented suspicion of infection, and 100 identified as having a negative MEWS and no suspicion of infection. A true positive case definition of having an ICD-10 inpatient discharge diagnosis of sepsis was set prior. The data was evaluated using a 2x2 table for sensitivity, specificity and predictive value. A survey was sent to 125 ED nurses to assess perceptions of the MEWS. Quantitative analysis was performed to estimate the number of manual MEWS’s done over a twelve-hour shift. Results showed 53 true-positive cases, 47 false-positive cases, 6 false-negative cases and 94 true-negative cases. The MEWS tool showed 89.83% sensitivity and 66.67% specificity at identifying physiological signs of sepsis. It showed a positive-predicative-value of 53% and a negative-predictive-value of 94%. False-positive cases were predominately associated with respiratory, skin and urinary infections. ED nurses supported the MEWS, but consensus was mixed on who should be screened and how often. A positive MEWS with clinical suspicion for infection expedites throughput for patients with sepsis, leading to faster evaluation, decreased time to confirmed diagnosis, and timely implementation of lifesaving treatment to improve patient outcomes despite its direct burden on nursing staff. 2017 Nursing eng Doctor of Nursing Practice Masters Thesis Nursing Jean Davison Thesis advisor Debbie Travers Thesis advisor Brian Seely Thesis advisor text 2017-05 University of North Carolina at Chapel Hill Degree granting institution Cameron Phillips Creator School of Nursing Evaluation of the Modified Early Warning Score (MEWS) Screening Tool for Physiological Signs of Sepsis and the Burden on Emergency Department Registered Nursing Staff Sepsis is the leading cause of death in hospitals worldwide and one of the most expensive reasons for hospitalization in the US. The CDC reported that sepsis begins outside of the hospital in approximately 80% of cases, and most septic patients first seek treatment at the emergency department (ED) where prompt recognition could decrease mortality. Screening tools used on inpatient hospital units utilize vital signs and laboratory data, however use is limited in the ED. To promote rapid, cost-effective screening for sepsis, the Modified Early Warning Score (MEWS) was implemented to screen adults for abnormal temperature, heart rate, blood pressure, respiratory rate, subjective decreased urine output and altered mental status. There is a lack of research evaluating the ability of the MEWS or any other tool to screen for physiological signs of sepsis in the ED. A retrospective chart review evaluated the accuracy and reliability of the MEWS screen. Two hundred cases were collected; 100 identified as having a positive MEWS and documented suspicion of infection, and 100 identified as having a negative MEWS and no suspicion of infection. A true positive case definition of having an ICD-10 inpatient discharge diagnosis of sepsis was set prior. The data was evaluated using a 2x2 table for sensitivity, specificity and predictive value. A survey was sent to 125 ED nurses to assess perceptions of the MEWS. Quantitative analysis was performed to estimate the number of manual MEWS’s done over a twelve-hour shift. Results showed 53 true-positive cases, 47 false-positive cases, 6 false-negative cases and 94 true-negative cases. The MEWS tool showed 89.83% sensitivity and 66.67% specificity at identifying physiological signs of sepsis. It showed a positive-predicative-value of 53% and a negative-predictive-value of 94%. False-positive cases were predominately associated with respiratory, skin and urinary infections. ED nurses supported the MEWS, but consensus was mixed on who should be screened and how often. A positive MEWS with clinical suspicion for infection expedites throughput for patients with sepsis, leading to faster evaluation, decreased time to confirmed diagnosis, and timely implementation of lifesaving treatment to improve patient outcomes despite its direct burden on nursing staff. 2017 Nursing eng Doctor of Nursing Practice Masters Thesis University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Jean Davison Thesis advisor Debbie Travers Thesis advisor Brian Seely Thesis advisor text 2017-05 Cameron Phillips Creator School of Nursing Evaluation of the Modified Early Warning Score (MEWS) Screening Tool for Physiological Signs of Sepsis and the Burden on Emergency Department Registered Nursing Staff Sepsis is the leading cause of death in hospitals worldwide and one of the most expensive reasons for hospitalization in the US. The CDC reported that sepsis begins outside of the hospital in approximately 80% of cases, and most septic patients first seek treatment at the emergency department (ED) where prompt recognition could decrease mortality. Screening tools used on inpatient hospital units utilize vital signs and laboratory data, however use is limited in the ED. To promote rapid, cost-effective screening for sepsis, the Modified Early Warning Score (MEWS) was implemented to screen adults for abnormal temperature, heart rate, blood pressure, respiratory rate, subjective decreased urine output and altered mental status. There is a lack of research evaluating the ability of the MEWS or any other tool to screen for physiological signs of sepsis in the ED. A retrospective chart review evaluated the accuracy and reliability of the MEWS screen. Two hundred cases were collected; 100 identified as having a positive MEWS and documented suspicion of infection, and 100 identified as having a negative MEWS and no suspicion of infection. A true positive case definition of having an ICD-10 inpatient discharge diagnosis of sepsis was set prior. The data was evaluated using a 2x2 table for sensitivity, specificity and predictive value. A survey was sent to 125 ED nurses to assess perceptions of the MEWS. Quantitative analysis was performed to estimate the number of manual MEWS’s done over a twelve-hour shift. Results showed 53 true-positive cases, 47 false-positive cases, 6 false-negative cases and 94 true-negative cases. The MEWS tool showed 89.83% sensitivity and 66.67% specificity at identifying physiological signs of sepsis. It showed a positive-predicative-value of 53% and a negative-predictive-value of 94%. False-positive cases were predominately associated with respiratory, skin and urinary infections. ED nurses supported the MEWS, but consensus was mixed on who should be screened and how often. A positive MEWS with clinical suspicion for infection expedites throughput for patients with sepsis, leading to faster evaluation, decreased time to confirmed diagnosis, and timely implementation of lifesaving treatment to improve patient outcomes despite its direct burden on nursing staff. 2017 Nursing eng Doctor of Nursing Practice Masters Thesis Nursing Jean Davison Thesis advisor Debbie Travers Thesis advisor Brian Seely Thesis advisor text 2017-05 University of North Carolina at Chapel Hill Degree granting institution Cameron Phillips Creator School of Nursing Evaluation of the Modified Early Warning Score (MEWS) Screening Tool for Physiological Signs of Sepsis and the Burden on Emergency Department Registered Nursing Staff Sepsis is the leading cause of death in hospitals worldwide and one of the most expensive reasons for hospitalization in the US. The CDC reported that sepsis begins outside of the hospital in approximately 80% of cases, and most septic patients first seek treatment at the emergency department (ED) where prompt recognition could decrease mortality. Screening tools used on inpatient hospital units utilize vital signs and laboratory data, however use is limited in the ED. To promote rapid, cost-effective screening for sepsis, the Modified Early Warning Score (MEWS) was implemented to screen adults for abnormal temperature, heart rate, blood pressure, respiratory rate, subjective decreased urine output and altered mental status. There is a lack of research evaluating the ability of the MEWS or any other tool to screen for physiological signs of sepsis in the ED. A retrospective chart review evaluated the accuracy and reliability of the MEWS screen. Two hundred cases were collected; 100 identified as having a positive MEWS and documented suspicion of infection, and 100 identified as having a negative MEWS and no suspicion of infection. A true positive case definition of having an ICD-10 inpatient discharge diagnosis of sepsis was set prior. The data was evaluated using a 2x2 table for sensitivity, specificity and predictive value. A survey was sent to 125 ED nurses to assess perceptions of the MEWS. Quantitative analysis was performed to estimate the number of manual MEWS’s done over a twelve-hour shift. Results showed 53 true-positive cases, 47 false-positive cases, 6 false-negative cases and 94 true-negative cases. The MEWS tool showed 89.83% sensitivity and 66.67% specificity at identifying physiological signs of sepsis. It showed a positive-predicative-value of 53% and a negative-predictive-value of 94%. False-positive cases were predominately associated with respiratory, skin and urinary infections. ED nurses supported the MEWS, but consensus was mixed on who should be screened and how often. A positive MEWS with clinical suspicion for infection expedites throughput for patients with sepsis, leading to faster evaluation, decreased time to confirmed diagnosis, and timely implementation of lifesaving treatment to improve patient outcomes despite its direct burden on nursing staff. 2017 Nursing eng Doctor of Nursing Practice Masters Thesis University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Jean Davison Thesis advisor Debbie Travers Thesis advisor Brian Seely Thesis advisor text 2017-05 Cameron Phillips Creator School of Nursing Sepsis is the leading cause of death in hospitals worldwide and one of the most expensive reasons for hospitalization in the US. The CDC reported that sepsis begins outside of the hospital in approximately 80% of cases, and most septic patients first seek treatment at the emergency department (ED) where prompt recognition could decrease mortality. Screening tools used on inpatient hospital units utilize vital signs and laboratory data, however use is limited in the ED. To promote rapid, cost-effective screening for sepsis, the Modified Early Warning Score (MEWS) was implemented to screen adults for abnormal temperature, heart rate, blood pressure, respiratory rate, subjective decreased urine output and altered mental status. There is a lack of research evaluating the ability of the MEWS or any other tool to screen for physiological signs of sepsis in the ED. A retrospective chart review evaluated the accuracy and reliability of the MEWS screen. Two hundred cases were collected; 100 identified as having a positive MEWS and documented suspicion of infection, and 100 identified as having a negative MEWS and no suspicion of infection. A true positive case definition of having an ICD-10 inpatient discharge diagnosis of sepsis was set prior. The data was evaluated using a 2x2 table for sensitivity, specificity and predictive value. A survey was sent to 125 ED nurses to assess perceptions of the MEWS. Quantitative analysis was performed to estimate the number of manual MEWS’s done over a twelve-hour shift. Results showed 53 true-positive cases, 47 false-positive cases, 6 false-negative cases and 94 true-negative cases. The MEWS tool showed 89.83% sensitivity and 66.67% specificity at identifying physiological signs of sepsis. It showed a positive-predicative-value of 53% and a negative-predictive-value of 94%. False-positive cases were predominately associated with respiratory, skin and urinary infections. ED nurses supported the MEWS, but consensus was mixed on who should be screened and how often. A positive MEWS with clinical suspicion for infection expedites throughput for patients with sepsis, leading to faster evaluation, decreased time to confirmed diagnosis, and timely implementation of lifesaving treatment to improve patient outcomes despite its direct burden on nursing staff. 2017 Nursing eng Doctor of Nursing Practice Masters Thesis University of North Carolina at Chapel Hill Graduate School Degree granting institution Jean Davison Thesis advisor Debbie Travers Thesis advisor Brian Seely Thesis advisor text 2017-05 Phillips_unc_0153D_16768.pdf uuid:b6ba0d6f-9333-463b-8691-9c4772826d76 2017-03-30T21:23:30Z proquest 2019-07-06T00:00:00 yes application/pdf 1303923