Dr Alison Pirret  BA, MA, PG Cert, PhD.

Nurse Practitioner, Critical Care Complex, Middlemore Hospital; Senior Lecturer, School of Nursing, Massey University, Auckland, NZ

Dr Alison Pirret is a Nurse Practitioner, Critical Care Complex, Middlemore Hospital, working clinically in an ICU outreach role.  Alison is Senior Lecturer in the School of Nursing, Massey University, Assistant Editor for the Journal of Intensive and Critical Care, and Chairperson of the New Zealand Health Quality and Safety Expert Advisory Group for the Deteriorating Patient Programme. Alison’s research interests include nasal high flow oxygen in ward patients, advanced nursing practice, diagnostic reasoning and systems to improve patient outcomes. Alison is author of the book “Acute Care Nursing: a Physiological approach to clinical assessment and patient care.”

The Trials and Tribulations of Transitioning to the New Zealand Early Warning Score (NZEWS) using Patientrack: A Local Experience

Many hospitals are now implementing NZEWS. This paper presents the challenges associated with implementing the NZEWS using ‘Patientrack’. Using a sequential design, concurrent data were collected between January and September 2017. Local EWS scores of PAR team referrals (n=100) were converted to NZEWSs and showed significant differences between the escalation responses of the two systems (Γ=0.67, P=<0.001) with a significant reduction in MET calls in surgical wards.  Local EWS scores (n=128) collected from six wards and converted to NZEWS also demonstrated differences in escalation responses (Γ=5.31, p=<0.001); most patients had low scores and very few had NZEWS 6-7. PAR team data identified most NZEWS 8-9 (n=8) did not warrant a MET call. Once implemented in pilot wards, ‘Patientrack’  data (n=594) identified most patients had low NZEWSs with very few NZEWSs 6-7 and PAR team referrals; PAR team data showed other patients  were referred to them and most patients clinically improved in the ward. The inbuilt ‘Patientrack’ reports provided limited data and identified the need to write our own reports to retrieve data from the data warehouse. NZEWS significantly differed from our local EWS and implementing it with ‘Patientrack’ with its limited reports proved challenging in determining the suitability of the NZEWS to meet the needs of our patient population and staffing resources.