Critical points of risk in registered nurses' use of a national early warning score - perceptions and challenges

Nadaf, Claire, Bench, Suzanne, Halpin, Yvonne and Terry, Louise (2024) Critical points of risk in registered nurses' use of a national early warning score - perceptions and challenges. Journal of Advanced Nursing, 81. pp. 4871-4882. ISSN 1365-2648

Text Nadaf 2025 JAN full article.pdf - Published Version Available under License Creative Commons Attribution. Download (545kB)

Abstract

im: To explore Registered Nurses' experiences and perceptions of using the National Early Warning Score in the U.K. as partof the recognition and management of acute adult patient deterioration.Design: Hermeneutic Phenomenological design.Methods: Sixteen Registered Nurses from a U.K. NHS hospital were interviewed using an interpretative phenomenologicalapproach (2019–2020).Results: Registered Nurses' use of NEWS highlighted 3 risk areas: delegation of vital sign monitoring to unregistered staffleading to uncertainty and delayed escalation, junior nurses' over-reliance on NEWS and deference to expertise, and seniornurses' self-management of deteriorating patients. The workplace culture revealed frequent compromises and limited learningopportunities.Conclusion: When using NEWS, failure to recognise associated risks threatens patient safety. Wrong decisions at the three‘pinch points’ may lead to missed chances in preventing deterioration. Incorrect judgements may lead to unrecognised patientdeterioration or inappropriate management leading to preventable adverse events.Implications for the Profession and Patient Care: The way in which NEWS is used by healthcare professionals brings inher-ent patient safety risks. Addressing education gaps and fostering a supportive culture in nursing, valuing and enhancing nurses'clinical judgement, is crucial for mitigating these risks and ensuring patient safety.Impact: The study deepens understanding of nurses' use of NEWS and identifies components affecting the recognition of patientdeterioration.Reporting Method: Adherence to the EQUATOR guidelines SRQR confirmed.Patient or Public Contribution: Service user involvement was included within the design of the study and ethical approval.

Item Type:	Article
Schools:	Centre for Workforce and Systems Innovation
Depositing User:	Bridget Roberts
Date Deposited:	20 May 2026 13:29
Last Modified:	20 May 2026 13:29
URI:	https://hsu.repository.guildhe.ac.uk/id/eprint/640

Actions (login required)

Edit Item