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Adult nursing
Study of nurses’ use of early warning scoring systems for patient deterioration highlights the need to strengthen nurses’ knowledge and confidence in their clinical judgement in using these tools
  1. Salma Rehman1,
  2. Parveen Ali2
  1. 1 School of Health and Social Care, University of Hull, Hull, UK
  2. 2 School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
  1. Correspondence to Dr Parveen Ali, School of Nursing and Midwifery, University of Sheffield, Sheffield S10 2TN, UK; parveen.ali{at}

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Commentary on: Wood C, Chaboyer W, Carr P. How do nurses use Early warning scoring systems to detect and act on patient deterioration to ensure patient safety? A scoping review. Int J Nursing Studies 2019;94:166–178.

Implications for practice and research

  • Educational opportunities involving simulation and reflective practice may help nurses improve their confidence in using their clinical judgement skills, as well as early warning scoring tools to identify and respond to deteriorating patients.

  • Further research is needed to explore nurses’ reluctance to activate the rapid response team when patients meet specific criteria in early warning scoring systems.


The use of early warning scoring tools plays an important role in the identification and management of patients at risk of deterioration1 in acute and non-acute settings.

However, the use of such tools in the practice setting and especially in non-acute settings, such as medical or surgical units, is not without …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.