[CG] MEWS guidance

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Maternity Early Warning Scoring: MEWS CHART - GUIDANCE FOR USE

Introduction

The purpose of this protocol is to ensure a standardised approach throughout GG&C to the use of the Maternity Early Warning Scoring (MEWS).

The MEWS calculated as part of vital signs assessment should be associatedwith appropriate escalation of treatment for deterioration in clinical condition and form part of a monitoring plan for an individual patient.

Policy

  • All in-patients will have a MEWS chart used to record observations
  • MEWS will supersede current charts
  • In Labour the partogram should be used, however if HDU care is required then a MEWS should be used along with the partogram.
  • If more than one MEWS chart is needed then they should be numbered sequentially and filed in the case notes.
  • MEWS charts must not be photocopied.
  • MEWS chart will be filed in the case notes when the patient is discharged.
  • Reviews and accompanying management plans must be appropriately documented, dated and timed with corresponding signature printed alongside.
  • Health care assistants/Students completing vital signs assessment must report any observations in the yellow or red zone to the midwife responsible for that patient immediately.
  • If a patient is not co-operative with having vital signs assessed and will not consent to the process this should be written on the MEWS chart, documented in the case notes and an explanation for patient’s behaviour sought. Remember metabolic (e.g. hypoglycaemia) or other serious pathologies (e.g. head injury) may cause atypical behaviour.

Frequency of routine observations

Ante-natal

All antenatal inpatient reviews/ admissions require 1 full set of observations to be completed on initial review. This will be followed by an individual management plan documented in the maternity records by the receiving Doctor/Midwife. This will detail amongst other things the frequency of observations thereafter.

Low-Risk Post-natal

Post-birth labour ward observations will be documented on the MEWS chart by Labour Ward Staff. This will be followed by 1 full set of observations on admission to the post-natal ward – if satisfactory - for daily recordings thereafter.

All other Post-Natal Women

  • 5 minute observations for the first 15 minutes
  • 15 minute observations for the next hour
  • 1 hourly observations for the first 4 hours
  • 4 hourly observations for the first 24 hours
  • If observations normal for 24 hours move to daily observations

Escalation of treatment flow chart

SBAR technique

Last reviewed: 22 December 2015

Next review: 10 January 2021

Author(s): Claire Rowan

Version: 2

Co-Author(s): Elaine Drennan

Approved By: Obstetrics Clinical Governance Group

Document Id: 404