Marjon Borgert

31 Standardized measurement of the Modified Early Warning Score Table 2. Description of compliance to the RRS protocol. Measurements on protocolized wards (N=3585) Measurements on control wards (N= 3013) 95% CI of % di erence P -value e Demographics of measurements Number of MEWS registered by nurse a , % (n/N) 70 (2513/3585) 2 (65/3013) 67.9 (66.3 to 70.0) < 0.001 Critical MEWS registered by nurse, % (n/N) 9 (338/3585) 1 (35/3013) 8.3 (7.3 to 9.3) < 0.001 Retrospectively calculated MEWS b , median (IQR) 0 (0 - 1) 0 (0 - 1) - - Retrospectively calculated critical MEWS, % (n/N) 11 (381/3585) 7 (217/3013) 3.4 (2.0 to 4.8) < 0.001 Compliance to measurement regime Days present on which MEWS could have been measured 3 or more times per day c , % (n/N) 44 (1205/2763) 56 (1558/2763) -12.8 (-15.4 to -10.2) < 0.001 Compliance of measurements taken ≥ 3 times per day, % (n/N) 68 (819/1205) - - - Measurements with retrospectively calculated MEWS ≥ 1, % (n/N) 59 (1745/2977) 41 (1232/2977) 17.2 (14.8 to 19.7) < 0.001 Compliance of MEWS registered by nurse if retrospective MEWS ≥ 1, % (n/N) - 4 (47/1232) - - Completeness and errors in measurements of all 9 parameters during single measurement No missing parameters, % (n/N) 43 (1552/3585) 1 (31/3013) 42.3 (40.6 to 44.0) < 0.001 1 missing parameter, % (n/N) 11 (391/3585) 1 (21/3013) 10.2 (9.2 to 11.3) < 0.001 2 missing parameters, % (n/N) 5 (174/3585) 1 (19/3013) 4.2 (3.5 to 5.0) < 0.001 3 or more missing parameters, % (n/N) 41 (1468/3585) 98 (2942/3013) -56.7 (-58.4 to -55.0) < 0.001 Errors in calculation d No errors, % (n/N) 20 (713/3585) 10 (309/3013) 9.6 (7.9 to 11.3) < 0.001 1 error, % (n/N) 35 (1270/3585) 6 (175/3013) 29.6 (27.8 to 31.4) < 0.001 2 errors, % (n/N) 14 (508/3585) 7 (203/3013) 7.4 (6.0 to 8.9) < 0.001 3 or more errors, % (n/N) 31 (1094/3585) 77 (2326/3013) -46.7 (-48.8 to -44.5) < 0.001 Due to rounding, percentages do not always add up to 100%. a This parameter describes if a nurse has registered a MEWS in the nursing chart, irrespective of correct calculation and/or based upon a complete set of measurements. b Retrospective calculation of the MEWS is performed by the researchers by calculation of the sub scores based upon the registered vital signs and subsequent determination of theMEWS according to the vital signs registered (irrespective of complete set presence). c The total number of nursing days per patient were calculated and cross checked if three or more measurements (irrespective of completeness and correctness) had taken place on the protocolized wards. d For this parameter, allocation of the sub scores (for each individual vital sign) including MEWS was calculated. Of note, errors were de ned as all vital signs missing as well as miscalculated and/or not recorded sub scores and MEWS. e Chi-square test