Webinar: Moving the goal posts – modifying the New Zealand early warning score

The Health Quality & Safety Commission held a webinar on 27 July 2018 about modifications to the New Zealand early warning score (NZEWS). 

Clinical lead of the Commission's patient deterioration programme, Dr Alex Psirides, presented about why modifications can be made, what to modify, the trigger or the response and how to modify. The presentation and recording of the webinar are available below.

Modifications may be made to the NZEWS triggers for individual patients when chronic disease, medication therapies, or other factors cause their vital signs to fall outside of the normal range on the national vital signs chart. However, detection of deterioration is delayed with two or more NZEWS parameters being modified and more extreme modifications on single parameters.

When making modifications the clinician must consider the clinical risk to the patient if vital sign abnormality is normalised. Clinical risk can be mitigated by ensuring modifications are discussed with a senior clinician and reviewed at regular intervals so they remain appropriate as the patient’s condition changes. The duration of all modifications must be documented to ensure that timely clinical review is undertaken.