Implementing the Modified Early Obstetric Warning Score (MEOWS) to Detect Early Signs of Clinical Deterioration and Decrease Maternal Mortality

Abstract

Purpose for the Program Modified Early Warning Score (MEOWS) was introduced to obstetric units in the United Kingdom to decrease maternal mortality by improving early detection of clinical signs of deterioration in women who were developing critical illnesses. Early warning scores have been used successfully in other areas, such as acute medicine, however these scores are not transferrable to obstetric patients because of the normal physiological changes in pregnancy. The parameters of vital signs for the MEOWS chart accounts for this. The existing Joint Commission standards require hospitals to have a process for identifying early warning signs of deterioration and for staff to seek assistance if this occurs. A sentinel event alert concerning increasing rates of maternal mortality in the United States recommends that specific changes in maternal vital signs and clinical condition should trigger a predetermined response. Proposed Change To quantify vital signs to identify early signs of deterioration. Implementation, Outcomes, and Evaluation A tool has been designed for the obstetric population and used in the United Kingdom; maternal deaths are decreasing and evaluation is ongoing. MEOWS is an innovative approach to care in the field of obstetrics. It is not currently widely used in North America; however, the United Kingdom is striving to make this the gold standard across all obstetric units. In a validation study, MEOWS had high sensitivity in predicting morbidity (89%) and reasonable specificity (79%) supporting its use for obstetric patients. The philosophy behind MEOWS reflects that the majority of validated obstetric emergency training courses, such as PROMPT, More OB, ALARM, and ALSO), encourage recognizing risk, implementing a coordinated approach to managing emergencies, open communication, and working within a multidisciplinary team. MEOWS is now being incorporated into a state-of-the-art new facility in the state of Qatar, which encourages innovative practice, multidisciplinary work, and evidence-based practice. MEOWS can be paper-based or used as part of an electronic medical record and provides a standardized approach to the assessment of maternal well-being. It has been incorporated into the rapid response policy, which ensures clarity of staff roles and responsibilities. Implications for Nursing Practice Implementing MEOWS could provide a rich opportunity for nurses to develop research programs, standardize care, and coordinate responses to deteriorating conditions. Modified Early Warning Score (MEOWS) was introduced to obstetric units in the United Kingdom to decrease maternal mortality by improving early detection of clinical signs of deterioration in women who were developing critical illnesses. Early warning scores have been used successfully in other areas, such as acute medicine, however these scores are not transferrable to obstetric patients because of the normal physiological changes in pregnancy. The parameters of vital signs for the MEOWS chart accounts for this. The existing Joint Commission standards require hospitals to have a process for identifying early warning signs of deterioration and for staff to seek assistance if this occurs. A sentinel event alert concerning increasing rates of maternal mortality in the United States recommends that specific changes in maternal vital signs and clinical condition should trigger a predetermined response. To quantify vital signs to identify early signs of deterioration. A tool has been designed for the obstetric population and used in the United Kingdom; maternal deaths are decreasing and evaluation is ongoing. MEOWS is an innovative approach to care in the field of obstetrics. It is not currently widely used in North America; however, the United Kingdom is striving to make this the gold standard across all obstetric units. In a validation study, MEOWS had high sensitivity in predicting morbidity (89%) and reasonable specificity (79%) supporting its use for obstetric patients. The philosophy behind MEOWS reflects that the majority of validated obstetric emergency training courses, such as PROMPT, More OB, ALARM, and ALSO), encourage recognizing risk, implementing a coordinated approach to managing emergencies, open communication, and working within a multidisciplinary team. MEOWS is now being incorporated into a state-of-the-art new facility in the state of Qatar, which encourages innovative practice, multidisciplinary work, and evidence-based practice. MEOWS can be paper-based or used as part of an electronic medical record and provides a standardized approach to the assessment of maternal well-being. It has been incorporated into the rapid response policy, which ensures clarity of staff roles and responsibilities. Implementing MEOWS could provide a rich opportunity for nurses to develop research programs, standardize care, and coordinate responses to deteriorating conditions.