Modified Early Warning Score (MEWS) for Clinical Deterioration

The MEWS can be used on all hospitalized patients to allow for the early detection of clinical deterioration and potential need for higher level of care.

• The Modified Early Warning System (MEWS) is a tool designed to identify patients with declining conditions.
• It has been shown to be superior to clinical judgement for this purpose.
• It was originally designed for nurses but can be used by any healthcare professional with adequate training.
• MEWS is based on the principle that clinical deterioration can be seen through subtle changes in a number of parameters as well as large changes within a single variable.
• The scale is calibrated to different populations and sometimes expanded to include additional parameters.
• While a score of 5 or more has been shown to be associated with a higher likelihood of admission to an intensive care unit or death, this threshold can be modified to accommodate different patient populations or clinical settings.
• The National Early Warning Score (NEWS) 2 was developed and updated by the Royal College of Physicians in the UK to standardize the identification and response to deteriorating patients.

• Patients with low MEWS can continue receiving their usual care and observation.
• Patients with high MEWS should be watched more attentively and considered for transfer to a higher care unit such as an ICU.