Early Warning Scoring (EWS)
The POTTS chart integrates routinely-collected vital signs and observations with accurate early warning scoring (EWS). The chart has eliminated the need to calculate the physiological score from an instruction table. Instead physiological scores are automatically allocated by ghosted values in the chart area; the only calculation needed is to total the scores to yield the EWS. The chart can be used across general medical and surgical wards. In a pilot trial the use of the new chart has improved compliance and accuracy of EWS recording to 95% - a twofold improvement on the two previous years’ audits. The improvement in compliance and accuracy of EWS recording may result in the earlier detection and treatment of patient with deteriorating conditions.
Early Warning Scores (EWS) were frequently absent from observation charts and often calculated incorrectly.
Scores are ghosted into the chart area, which minimises scoring errors. Light yellow shading leads the eye to a total EWS at the bottom of the page. All health staff are responsible for the accuracy and entering of the observations they take and are required to indicate actions taken when trigger thresholds are reached.
Errors due to chart layout have been greatly reduced and errors associated with poor instructions have been eliminated. The following developments have resulted in greater accuracy and compliance in chart completion, ensuring earlier identification of patients with deteriorating conditions:
- The POTTS chart has all the observations leading to an EWS on one side of an A3 page.
- The need for an EWS instruction table has been eliminated.
- In the POTTS chart the score is ghosted in each box completed, helping to improve the EWS accuracy.
- Effective colour shading highlights different fields on the chart and guides the member of staff to the relevant sections. For example all the physiological scores entered into the light yellow boxes on the main chart are added up and the total (the EWS) is entered into the bright yellow box at the bottom of the page.
- There is a space for the nurse’s signature against every set of observations; the nurses now have greater responsibility for recording the observations accurately as they are legally accountable for their own record-keeping.
- Other important observations are arranged on the back of the chart with a ‘flip-over’ section. This allows the key observations (oxygen saturation, nausea and vomiting scoring, pain scoring, respiratory rate, blood pressure and pulse rate) to be viewed on the same side without having to remove the chart from the folder. The numbered columns on the back page align with those on the main chart.
The chart was designed to remain with the patients throughout their stay, reducing paperwork and ensuring that patients’ records are complete.
- Ghosted scoring aids frequent and accurate EWS recording.
- Attractive user-friendly design.
- Complies with many of the NICE 50 guidelines.
- An Excel version of the package incorporating the chart, protocol and algorithm will be sent with a release code to enable adaptation of the chart for use within the adopting organisation.
Pricing & Availability
This product is FREE to NHS organisations. Please email Emma Malpeli at firstname.lastname@example.org for further information and ordering.
For non-NHS organisations the product is available per hospital for £500.00 plus VAT. Please contact Dr Robert Oakey, Research & Development Fellow, University Hospitals of Morecambe Bay NHS Trust. Tel: 01524 583916. Email Robert.Oakey@mbht.nhs.uk for further information and ordering.