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Evaluation of the Effect of the Modified Early Warning System on the Nurse-Led Activation of the Rapid Response System

Stewart, Jacqueline DNP, RN, CEN, CCRN, FAEN; Carman, Margaret DNP, MSN, RN, CEN, ACNP; Spegman, Adele PhD, RN; Sabol, Valerie K. PhD, ACNP-BC, GNP-BC

doi: 10.1097/NCQ.0000000000000048

The Modified Early Warning System (MEWS) is a scoring rubric used to detect the earliest signs of a change in a patient's condition. This mixed-methods study used pre- and postintervention data to describe the impact of the MEWS on the frequency of rapid response system activations and cardiopulmonary arrests among patients admitted to medical-surgical units. Focus groups of nursing staff provided insight into the factors that influence how nurses use the MEWS at the bedside as a framework to identify, intervene, and manage patients in need of an advanced level of care.

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Wilkes University School of Nursing, Wilkes-Barre, Pennsylvania (Dr Stewart); Duke University School of Nursing, Durham, North Carolina (Drs Carman and Sabol); and Geisinger Medical Center, Danville, Pennsylvania (Dr Spegman).

Correspondence: Jacqueline Stewart, DNP, RN, CEN, CCRN, FAEN, Wilkes University School of Nursing, 84 W South St, Wilkes Barre, PA 18766 (

The authors have no conflicts of interest to report.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Accepted for publication: December 15, 2013

Published ahead of print: January 16, 2014

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