Audit

INSTRUCTIONS FOR THE OBSERVER

1. Ask your colleague to talk you through what they will do to take systematic observations of the patient

2. Show the checklist and check any misconceptions (if time permits ask a 'what if question; e.g. if the patient is not responsive what will you do?)

3. Observe your colleague doing a systematic assessment and nEWS.

4. Once the assessment is complete, check the documentation and probe the interpretation of results ( Are you concerned? Why? Why not?)

5. Send your observations in an email for your colleague's portfolio and for revalidation

CLINICAL OBSERVATIONS - nEWS

1. Introduces themselves to the patient, explains the task appropriately and gains consent

2. Ensures the patient's name and hospital number are correctly documented on the EWS chart

3. Identifies the radial pulse and correctly and identifies the rate and rhythm (e.g. was it rapid?)

4. Identifies correctly and records the respiratory rate and pattern (e.g. shallow breaths? use of accessory muscles?)

5. Records accurate oxygen saturation and understands the significance of the heart rate display (e.g. compares with manual pulse check for accuracy)

6. Records the flow rate of oxygen, the device in use and identifies if the patient is within the prescribed saturation parameters

7. Records reads and documents the temperature correctly

8. Performs an accurate assessment of AVPU asking open questions

9. In measuring blood pressure, selects the correct size BP cuff, positions it correctly on the patient's arm, and uses automated medical device appropriately to obtain BP.

10. Records EWS parameters correctly,, calculates score accurately and documents

11. Interprets the EWS score, identifies appropriate escalation actions and documents.

12. Chooses the appropriate frequency of observations based on EWS

13. Comments and action plan (e.g. positives, areas for improvement)

15. How would you rate the performance overall?

Observer Signature
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.