National early warning system adherence: Is nurses’ clinical competence involved associated with protocol in a hospital in Indonesia?

Priyo Sasmito; Ahmadi Ahmadi; Leli Mulyati; Fika Indah Prasetya; Andi Maryam; Treesia Sujana; Yuyun Tafwidhah; Andi Elis

doi:10.33024/minh.v7i2.180

Authors

Priyo Sasmito Universitas Ichsan Satya
Ahmadi Ahmadi Fakultas Ilmu Kesehatan Universitas Nazhatut Thullab Al-Muafa Sampang
Leli Mulyati Poltekkes Kemenkes Bengkulu
Fika Indah Prasetya Prodi S1 Keperawatan, STIKes Bhakti Al-Qodiri
Andi Maryam Institut Kesehatan dan Bisnis Kurnia Jaya Persada Palopo
Treesia Sujana Fakultas Kedokteran, Universitas Padjajaran
Yuyun Tafwidhah Prodi Keperawatan, Universitas Tanjungpura
Andi Elis Institut Kesehatan dan Bisnis Kurnia Jaya Persada

DOI:

https://doi.org/10.33024/minh.v7i2.180

Keywords:

Adherence, Clinical Competence, National Early Warning Score, Nurse, Protocol

Abstract

Background: The implementation of the Early Warning System (EWS) in developing countries still faces many obstacles. The National Early Warning Score (NEWS) is one of the most frequently used EWS. The factors affecting its compliance are still being studied.

Purpose: To analyze the involvement of nurse clinical competence in adherence to the National Early Warning Score (NEWS) protocol in a hospital in Indonesia.

Method: This study is an observational analytic study with a cross-sectional approach to nurses in the medical ward. Nurse characteristics consisting of age, gender, education level, work experience, and knowledge of NEWS were measured and recorded. Nurse clinical competence level is the main independent variable. The outcome measured was nurse adherence to the protocol which was assessed by looking at the records in the NEWS observation sheet. Data was analyzed using Chi-Square, Fisher Exact Test, and Spearman Rho.

Results: Thirty-five nurses were involved in the study. Respondent were 38.7 years old on average, had an average work experience of 7.1 years, and had an average knowledge of NEWS of 77.2+7.2 (good). The majority of respondent were females (20/57.1%), had diploma education (20/57.1), and were at clinical competency level I (26/74.3%). In the NEWS score < 5, most respondent adhered to the protocol (21/60.0%), but the majority did not adhere to the protocol at the NEWS score ˃.6 (28/80.0%). A p-value of > 0.05 was obtained in the analysis of the relationship between age, education level, and work experience with protocol adherence on a NEWS score of ˃.6

Conclusion: The majority of respondent have not adhered to the NEWS ˃.6 protocol. There is a significant relationship between age, education level, work experience, and NEWS ˃.6 protocol adherence. There was no relationship between nurses' clinical competence and adherence to the NEWS protocol at either a score of < 5 or ˃.6. Further studies are needed to confirm the results of this study.