Maternity early warning score (MEWS/MOEWS)

What it is

MEWS is the Maternity Early Warning Score and MOEWS is the Modified Obstetric Early Warning Score. The document defines the MEWS and MOEWS standard and chart used in the maternity units, guides the application of their parameters for all obstetric nursing staff in addition to routine monitoring of maternity patients, and aims to improve patient outcomes through risk assessment in order to prevent further deterioration.

Five words are defined before anything else. Monitoring is a continuous or frequent periodic clinical assessment. Vital signs are the measurements of pulse rate, respiration rate, body temperature, blood pressure and pain. Observation is an objective evaluation made by a nurse of the various aspects of a patient's condition, including general appearance, emotional affect, nutritional status, habits and preferences, as well as body temperature, skin condition, and any abnormal processes, including those of which the patient complains. Variance is an observation that varies from the norm or standard, or any variation in a routine, which needs to be reported immediately. Deterioration is the worsening of a patient's condition as indicated by vital signs and observation.

AVPU is an acronym used to assess a patient's level of consciousness: A = Alert; V = responds to Voice; P = responds to Pain; U = Unresponsive.

The numbers themselves are not in this document; they are in the MEWS and action plan flowchart (Appendix A), the MOEWS Chart (Appendix B), and the MOEWS Action Plan (Appendix C).