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All Journal International Journal of Public Health Excellence (IJPHE) Malahayati International Journal of Nursing and Health Science
Arifani, Nisa
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Health Professions Medicine & Pharmacology Nursing Public Health

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A Systematic Review: Early Warning System for Hospital Wards Sasmito, Priyo; Aljufri, Salim; Mulyati, Leli; Rasmita, Dina; Syafridawita, Yetti; Deviana, Elina; Komariah, Elis; Gayatri, Sri Wahyuni; Arifani, Nisa
International Journal of Public Health Excellence (IJPHE) Vol. 3 No. 2 (2024): January-May
Publisher : PT Inovasi Pratama Internasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55299/ijphe.v3i2.782

Abstract

Most of the unexpected events occur in the hospital wards. An Early Warning System (EWS) is a system created to identify worsening patients outside the Intensive Care Unit (ICU). EWS is one of the requirements that must be met to get hospital accreditation. Hospitals have to choose the appropriate EWS to get optimal outcomes. This study aims to describe some of the EWS in the wards that have been researched and developed, as well as their performance in predicting severe adverse events (SAE). This study is a literature review design, conducting a systematic review by selecting relevant articles on Pub Med and Science Direct using the keyword "Early Warning Systems" in the 2018-2023 period. Out of 269 articles, only 12 articles that met the criteria. The selected articles are then systematically reviewed and analyzed. Based on the extraction results of 12 articles, 9 EWS were grouped into National Early Warning Score (NEWS) and its variants, Modified Early Warning Score (MEWS) and its variants, and EWS integrated with Electronic Medical Record (EMR). In choosing an EWS, hospitals must consider the complexity of the cases being managed and the capabilities of existing resources. The recommended EWS in hospital wards with limited resources is weighted EWS or EWS with combinations, such as NEWS and MEWS with variants. Meanwhile, hospitals that have used EMR can choose EWS integrated with EMR to increase their predictive value for SAE, as well as improve protocol compliance.
Serious adverse events and missed observations impact of limited resources of nurses based on national early warning score (NEWS) Sasmito, Priyo; Mulyati, Leli; Prasetya, Fika Indah; Bernadus, Janno Berty Bradly; Sumartini, Sri; Arifani, Nisa; Tafwidhah, Yuyun; Ulfah, Diana
Malahayati International Journal of Nursing and Health Science Vol. 7 No. 4 (2024): Volume 7 Number 4
Publisher : Program Studi Ilmu Keperawatan-Fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v7i4.430

Abstract

Background: Since become an obligation for hospital, Early Warning System (EWS) are widely used. National Early Warning Score (NEWS) is common EWS adopted in Indonesia. There are not many studies evaluating the implementation of the in hospitals with limited resources in Indonesia. Purpose: To analyze the NEWS performance in the medical ward at one regional hospital in Serang District, Banten Province, Indonesia. Method: Observational analytic study with retrospective approach using NEWS observation sheet of 163 medical adult patients. NEWS's performance was assessed by analyzing the amount of observation that was not carried out in the first 24 hours of hospitalization according to hospital safety protocols. The observed outcome was the occurrence of serious adverse events (SAE), unplanned Intensive Care Unit (ICU) admission, and in-hospital mortality.  The data analyzed with Fisher Exact Test and Spearman Rho. Results: Participants' age mean of 48.2 years old (range 17-85). Most were male (87/53.4%) with a NEWS score of 0 in the first 24 hours of hospitalization (91/55.8%). Of 72 (44.2%) missed observation patients, 8 (4.9%) experienced SAE, 5 (3.1%) transferred to the ICU, and 3 (1.8%) died in the ward. There are significant relationship (p-value 0.001) between missed observation and the occurrence of SAE and unplanned ICU admission (p-value 0.015). There is no relationship between missed observation and in-hospital mortality. Conclusion: About forty percent of NEWS observation frequency in medical wards is still not under safety protocols that have been made by the hospital. Missed observation associated with SAE and unplanned ICU admission. Hospital stakeholders need to evaluate the implementation of NEWS in the hospital ward and take strategic action to increase its effectiveness.
Advanced cardiac life support in out-of-hospital cardiac arrest: A case study Sasmito, Priyo; Kosasih, Cecep Eli; Sumartini, Sri; Tafwidhah, Yuyun; Arifani, Nisa; Apparesya, Nabila Afifah; Kusuma, Widya Tresna; Amaliah, Lili
Malahayati International Journal of Nursing and Health Science Vol. 7 No. 7 (2024): Volume 7 Number 7
Publisher : Program Studi Ilmu Keperawatan-Fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v7i7.619

Abstract

Background: Public Health Center (PHC), especially in rural areas, is one of the primary healthcare facilities that have an important role in the chain of survival of out-of-hospital cardiac arrest (OHCA) patients. Despite of limited facilities, prehospital resuscitation can be performed by optimizing the available emergency facilities and infrastructure. Purpose: To provide a comprehensive overview of the resuscitation management of OHCA patients at a PHC in East Java Province in Indonesia. Method: Case study of a 43-year-old woman who was brought to PHC by residents after suddenly losing consciousness while working. The clinical condition when the patient arrived was unresponsive, no pulse, no respiratory effort, cold extremities, and oxygen saturation of 80%, the patient was medically diagnosed as OHCA. Results: Resuscitation organization was carried out by involving 1 doctor, 2 nurses, and 1 midwife. The patient was given basic life support (BLS) and Advanced Cardiac Life Support (ACLS) by optimizing diagnostic tools, airway, breathing, circulation, and available drugs. The patient successfully Return of Spontaneous Circulation (ROSC) after the third cycle and successfully reached the referral hospital to receive further life support. Conclusion: ACLS in the prehospital setting at PHC in Indonesia has a potential to be performed. Inter-professional collaboration, airway, breathing, and circulation optimization in providing BLS and ACLS on OHCA patients can increase the patient's chance of getting further care in the hospital.
Co-Authors Aljufri, Salim Amaliah, Lili Apparesya, Nabila Afifah Bernadus, Janno Berty Bradly Cecep Eli Kosasih Deviana, Elina Diana Ulfah Gayatri, Sri Wahyuni Komariah, Elis Kusuma, Widya Tresna Mulyati, Leli Prasetya, Fika Indah Rasmita, Dina Sasmito, Priyo Sri Sumartini Syafridawita, Yetti Tafwidhah, Yuyun