AimTo explore Registered Nurses' experiences and perceptions of using the National Early Warning Score in the U.K. as part of the recognition and management of acute adult patient deterioration.DesignHermeneutic Phenomenological design.MethodsSixteen Registered Nurses from a U.K. NHS hospital were interviewed using an interpretative phenomenological approach (2019–2020).ResultsRegistered Nurses' use of NEWS highlighted 3 risk areas: delegation of vital sign monitoring to unregistered staff leading to uncertainty and delayed escalation, junior nurses' over‐reliance on NEWS and deference to expertise, and senior nurses' self‐management of deteriorating patients. The workplace culture revealed frequent compromises and limited learning opportunities.ConclusionWhen using NEWS, failure to recognise associated risks threatens patient safety. Wrong decisions at the three ‘pinch points’ may lead to missed chances in preventing deterioration. Incorrect judgements may lead to unrecognised patient deterioration or inappropriate management leading to preventable adverse events.Implications for the Profession and Patient CareThe way in which NEWS is used by healthcare professionals brings inherent patient safety risks. Addressing education gaps and fostering a supportive culture in nursing, valuing and enhancing nurses' clinical judgement, is crucial for mitigating these risks and ensuring patient safety.ImpactThe study deepens understanding of nurses' use of NEWS and identifies components affecting the recognition of patient deterioration.Reporting MethodAdherence to the EQUATOR guidelines SRQR confirmed.Patient or Public ContributionService user involvement was included within the design of the study and ethical approval.

中文翻译：

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注册护士使用国家早期预警评分的关键风险点——看法和挑战


目的探讨注册护士在英国使用国家早期预警评分作为识别和管理急性成年患者恶化的一部分的经验和看法。设计诠释学现象学设计。方法使用解释性现象学方法采访了来自英国 NHS 医院的 16 名注册护士 （2019-2020）。结果注册护士对 NEWS 的使用突出了 3 个风险领域：将生命体征监测委托给未注册工作人员导致不确定性和延迟升级，初级护士过度依赖 NEWS 并尊重专业知识，以及高级护士对恶化的患者进行自我管理。职场文化揭示了频繁的妥协和有限的学习机会。结论使用 NEWS 时，未能识别相关风险会威胁患者安全。在三个“夹点”的错误决定可能会导致错失防止恶化的机会。不正确的判断可能导致未被识别的患者恶化或管理不当，从而导致可预防的不良事件。对行业和患者护理的影响医疗保健专业人员使用 NEWS 的方式带来了固有的患者安全风险。解决教育差距并培养护理支持性文化，重视和增强护士的临床判断，对于减轻这些风险和确保患者安全至关重要。影响该研究加深了对护士使用 NEWS 的理解，并确定了影响识别患者恶化的因素。报告方法：确认遵守 EQUATOR 指南。患者或公众贡献Service 用户的参与被纳入研究的设计和伦理批准中。