Strengths and limitations of early warning scores: A systematic review and narrative synthesis

摘要: Abstract Background Early warning scores are widely used to identify deteriorating patients. Whilst their ability predict clinical outcomes has been extensively reviewed, there no attempt summarise the overall strengths and limitations of these for patients, staff systems. This review aims address this gap in literature guide improvements optimization patient safety. Methods A systematic was conducted MEDLINE ® , PubMed, CINAHL The Cochrane Library September 2016. citations reference lists selected studies were reviewed completeness. Studies included if they evaluated vital signs monitoring adult human subjects. regarding paediatric population excluded, as describing development or validation models. narrative synthesis qualitative, quantitative mixed- methods undertaken. Findings 232 met inclusion criteria. Twelve themes identified from data: Strengths early prediction value, influence on outcomes, cross-specialty application, international relevance, interaction with other variables, impact communication opportunity automation. Limitations sensitivity, need practitioner engagement, reaction escalation judgment, intermittent nature recording. known have good predictive value deterioration shown improve across a variety specialties settings. is partly due facilitation between healthcare workers. There evidence that generic suffers comparison specialty-specific scores, sensitivity can be improved by addition variables. They also prone inaccurate recording user error, which overcome Conclusions provide right language environment timely care. limited user-dependent nature, partially automation new continuous technologies, although judgment remains paramount.