This retrospective, descriptive study was designed to (a) determine if the Modified Early Warning Score risk assessment tool identified moderate to high risk patients prior to the activation of the Rapid Response Team (b) determine how much time occurred from the onset of clinical deterioration until activation of the Rapid Response Team. A Modified Early Warning Score (MEWS) was applied to the documented vital signs in the medical records of a convenience sample of 108 adult patients between the ages of 19 and 99 years of age who had experienced an activation of the Rapid Response Team (RRT). A risk assessment score was given for the time of the RRT activation as well as every previously documented instance of vital signs prior to the RRT call until the MEWS score reached a low risk score of 0 to 1. Of the 108 subjects, 36 subjects had a low risk (score 0 to 1) MEWS at the time of the RRT activation; 72 subjects had a moderate (score of 2 to 3) or high (score 4 or greater) risk MEWS score at the time of the RRT activation. Ten (10.14) hours was the average amount of time earlier deterioration could have been detected if a MEWS system had been in place. The data from this study indicate a need for more frequent observation and documentation of vital signs by nursing staff as the overall average length of time between vital signs collected (MEWS applied) was 291.60 minutes (4.86 hours) when clinical deterioration was evident. These data show that there is a delay in activation of the Rapid Response Team and that implementation of the MEWS system would increase RRT awareness of patients with critically abnormal vital signs so that they can be assessed and clinical deterioration treated to prevent a catastrophic event from occurring.


Sue Ellen Bell

First Committee Member

Hans-Peter de Ruiter

Date of Degree




Document Type



Master of Science in Nursing (MSN)


School of Nursing


Allied Health and Nursing

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License



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