Individual Early Warning Score (I-EWS) of Nielsen et al

Description

The Individual Early Warning Score (I-EWS) is a modification of NEWS early warning score. This is a tweaking of the score to reflect the patient's current status. The authors are from multiple institutions in Denmark and New Zealand.

The IEWS consists of recording the NEWS, then having the nurse adjust based on the patient's current condition.

IEWS at a given moment =

= (most recent NEWS) + (current clinical adjustment)

where the NEWS ranges from 0 to 20.

Current Condition	Clinical Adjustment
EWS matches clinical status	0
clinical status looks better than the NEWS indicates	subtract an integer from -1 to -4
clinical status worse than indicated by NEWS	add an integer from 1 to 6

Adjusted Score	Minimum Observation Period	Escalation
<= 1	every 12 hours	none unless ordered
2	every 6 hours	contact supervising nurse; notify doctor
3 to 6	every 4 hours	doctor notified
7 or 8	every hour	call on-call doctor
>= 9	every 30 minutes	call on-call doctor who may call back-up

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