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Nurses’ perception on Initial Implementation of Early Warning System: A Mixed Method Study

Jurnal Keperawatan Soedirman · Vol. 17 No. 1 (2022) · pp. 29–35

DOI
10.20884/1.jks.2022.17.1.4927
ISSN
2579-9320, 1907-6673
Published
2022-04-14
Publisher
Fakultas Ilmu-ilmu Kesehatan
Language
eng

Abstract

The early warning system (EWS) has been decided as a new standard for Indonesian hospitals. The main objective of EWS implementation is to help nurses quickly recognize and react to deteriorating patients. This study explores how EWS contributes to nurses’ clinical decisions around patient deterioration. The research design for this study was mixed-method sequential explanatory. A purposive sampling approach was used to recruit the participants. Closed and open-ended questionnaires were distributed (n = 53) to adult unit nurses and the data was analyzed by using descriptive statistics. Focus group discussions were conducted to evaluate the implementation process and the results obtained were analyzed by using thematic analysis. Both data were integrated by using a joint display table. We found that 79% of nurses indicated that they needed education about how to use the EWS and 92% of nurses required education on physiology and management of the deteriorating patient. Three themes emerged: (1) the nurses’ experience of EWS Implementation, (2) the impact of EWS implementation, and (3) ameliorating the EWS Implementation. The participants showed that the EWS has been used for the assessment, documentation, and communication process of deteriorating patient management. The EWS is a complex tool for nurses, and they need support from stakeholders to maintain and optimize the advantages.

Collaboration network of the authors

20 authors · 67 co-authorship links · 22 across different organisations

Hover or tap a name to highlight its co-authors. Double-click to open the author's page.

  • Universitas Gadjah Mada
  • Rumah Sakit Umum Pusat Dr. Sardjito
  • Universitas Jember
  • Poltekkes Kemenkes Malang
  • Affiliation unknown
  • Different organisations
  • Same organisation
  • Affiliation unknown
  • Thicker line = more joint articles · bigger circle = more articles
Show as table
Co-authorOrganisationJoint articles
Desy ListyaningrumUniversitas Jember1
Irni Fuzi WijayantiPoltekkes Kemenkes Malang1
Setyo TriatmojoAffiliation unknown1
Hersinta Retno MartaniUniversitas Gadjah Mada1
Yunita CahyaningsihRumah Sakit Umum Pusat Dr. Sardjito1
GunawanRumah Sakit Umum Pusat Dr. Sardjito1
Hardi ApriyantoRumah Sakit Umum Pusat Dr. Sardjito1
Endang SuryaningsihAffiliation unknown1
Husna YulianingsihUniversitas Gadjah Mada1
Christantie EffendyUniversitas Gadjah Mada1
Syahirul AlimAffiliation unknown1
Rahmah Yanita KusumaAffiliation unknown1
Ariani Arista Putri PertiwiAffiliation unknown1
Sugeng SugengAffiliation unknown1
Nyoman KertiaAffiliation unknown1
Probosuseno ProbosusenoAffiliation unknown1

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) http://jos.unsoed.ac.id/index.php/jks/oai, first harvested 9 Nov 2026, last seen 9 Nov 2026.
Original metadata (oai_dc) 
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	<dc:title xml:lang="en-US"> Nurses’ perception on Initial Implementation of Early Warning System: A Mixed Method Study</dc:title>
	<dc:creator>Sujalmo, Purwadi</dc:creator>
	<dc:creator>Setiyarini, Sri</dc:creator>
	<dc:creator>Walsh, Kenneth</dc:creator>
	<dc:creator>Greenwood, Melanie</dc:creator>
	<dc:description xml:lang="en-US">The early warning system (EWS) has been decided as a new standard for Indonesian hospitals. The main objective of EWS implementation is to help nurses quickly recognize and react to deteriorating patients. This study explores how EWS contributes to nurses’ clinical decisions around patient deterioration. The research design for this study was mixed-method sequential explanatory. A purposive sampling approach was used to recruit the participants. Closed and open-ended questionnaires were distributed (n = 53) to adult unit nurses and the data was analyzed by using descriptive statistics. Focus group discussions were conducted to evaluate the implementation process and the results obtained were analyzed by using thematic analysis. Both data were integrated by using a joint display table. We found that 79% of nurses indicated that they needed education about how to use the EWS and 92% of nurses required education on physiology and management of the deteriorating patient. Three themes emerged: (1) the nurses’ experience of EWS Implementation, (2) the impact of EWS implementation, and (3) ameliorating the EWS Implementation. The participants showed that the EWS has been used for the assessment, documentation, and communication process of deteriorating patient management. The EWS is a complex tool for nurses, and they need support from stakeholders to maintain and optimize the advantages.</dc:description>
	<dc:publisher xml:lang="en-US">Fakultas Ilmu-ilmu Kesehatan</dc:publisher>
	<dc:date>2022-04-14</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
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	<dc:type xml:lang="en-US">Peer-reviewed Article</dc:type>
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	<dc:identifier>https://jos.unsoed.ac.id/index.php/jks/article/view/4927</dc:identifier>
	<dc:identifier>10.20884/1.jks.2022.17.1.4927</dc:identifier>
	<dc:source xml:lang="en-US">Jurnal Keperawatan Soedirman; Vol 17 No 1 (2022): Jurnal Keperawatan Soedirman (JKS); 29-35</dc:source>
	<dc:source>2579-9320</dc:source>
	<dc:source>1907-6673</dc:source>
	<dc:source>10.20884/1.jks.2022.17.1</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>https://jos.unsoed.ac.id/index.php/jks/article/view/4927/2849</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2022 Jurnal Keperawatan Soedirman</dc:rights>
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