Improving early warning scores in acute surgical wards North Bristol NHS Trust

The North Bristol NHS Trust team developed a training programme to support effective use of an early warning score system that was in use on acute surgical wards. The system produces a score based on a patient's blood pressure, pulse rate, breathing rate, oxygen level and temperature, to help staff recognise when someone is becoming unwell and requires intervention.

The team devised two role-play scenarios based on incidents that had happened in the trust. Groups of trainees worked through the scenarios and discussed what went well and what went less well. The project aimed to show that training teams of staff in a realistic work environment could improve patient care at the same time as boosting staff morale and saving money for the hospital and the primary care trust. 

Who was involved

Staff working on acute surgical wards took part in the training in small groups made up of nurses, health care assistants and doctors who would normally work together.

Outcomes

After the training was introduced, it was twice as likely that a doctor would attend to review a deteriorating patient within 15 minutes, in line with hospital policy.

The project changed staff attitudes to training and other departments in the trust, including elderly care and staff development, showed interest in taking a similar approach to training. 

Challenges

Nurses and health care  assistants were initially worried that the training was being used to assess them and select people for redundancy, while doctors felt that the training was a waste of their time. However, most participants felt very differently after taking part.