Effect of MEWS Education on Nurses’ Knowledge and Early Detection of Patient Deterioration Before ICU Admission in Adult High Dependency Units

Abstract

Background: Early recognition of patient deterioration is a cornerstone of patient safety in acute and high-dependency care settings. Hospitalized patients frequently exhibit physiological warning signs hours before clinical collapse or unplanned intensive care unit (ICU) admission; however, delayed recognition and escalation remain common challenges. The Modified Early Warning Score (MEWS) is a validated physiological scoring system designed to support early detection of deterioration, yet inconsistent use and limited nurse training reduce its effectiveness.

Objectives: To evaluate the effectiveness of a structured MEWS educational intervention on nurses’ knowledge and early detection of patient deterioration before ICU admission in adult medical High Dependency Units.

Methods: A quasi-experimental pre-test–post-test design with a control group was employed in two High dependency units. Registered nurses working in two adult medical HDUs were recruited. Nurses’ knowledge was assessed using a 20-item structured questionnaire, administered before and after the intervention.

Results: Baseline assessment revealed limited knowledge of the Modified Early Warning Score (MEWS) in both control and intervention units. Following the structured educational intervention, nurses in the intervention unit demonstrated a substantial improvement in post-test knowledge scores compared to pre-test results, whereas minimal change was observed in the control unit. Post-intervention clinical data from the intervention unit showed a reduction in unplanned ICU transfers, code blue events, and unplanned intubations, along with a decreased average length of stay in the HDU, indicating improved early detection of patient deterioration.

Conclusion: Structured MEWS education significantly enhances nurses’ knowledge and supports early detection of patient deterioration. Integrating regular MEWS training into institutional protocols may strengthen patient safety culture and improve clinical outcomes.