Disease progression often differs among patients. According to study findings, changes in vital signs, blood oxygen saturation, and consciousness are each related closely to acute deterioration in disease status (Sutherasan et al., 2018). The early warning system (EWS) is a predictive approach to detecting deterioration in disease condition based on the observation of slight variations in patient vital signs and clinical symptoms (Smith et al., 2014). Most patients experience changes in specific physiological variables before experiencing a cardiac arrest. The implementation of a comprehensive EWS facilitates the early identification and prevention of serious adverse events such as unexpected cardiac arrest and death, and may help reduce the risk of other unexpected events as well (Gerry et al., 2017). For medical team members, the use of EWS not only permits the detection of changes in patient condition at an early stage but also allows healthcare workers to respond more proactively and effectively. Moreover, EWS has been shown to improve communication, increase cooperation, and strengthen personal responsibility among healthcare workers (Burns et al., 2018). In summary, implementing EWS allows the prompt initiation of appropriate patient treatment and helps improve patient-care outcomes. While recognizing the importance of incorporating EWS into patient care in clinical and home-based institutions as an important strategy to protecting the lives of patients, appropriate standardized warning systems must be tailored to address different disease characteristics. Changes in patient condition are traditionally addressed through nursing assessment followed by physician notification and response. However, this process may be affected by factors such as assessment accuracy, cultural differences, confidence, and past experiences that may result in decision-making errors (Wood, Chaboyer, & Carr, 2019). The integration of EWS and medical informatics technology is expected to reduce the risks of human-interpretation-related omissions and errors (Downey, Tahir, Randell, Brown, & Jayne, 2017). Although the use of medical informatics technology to enhance EWS remains in its infancy, this will certainly be one of the future trends in patient care. The articles in this issue, in addition to introducing EWS, elucidate the current application of EWS in clinical critical conditions and introduce how informatics technology is being combined in home EWS applications. These articles comprise a rich body of information on EWS that may referenced in clinical nursing care, home care, education, and research.
Title: 守護病人生命的早期警示系統.
疾病的進展往往因個體的差異性而有所不同，根據研究發現生命徵象、血氧飽和度和意識狀態呈現出的變化，與疾病的急性惡化有著密不可分的相關性（Sutherasan et al., 2018），而早期警示系統（early warning system, EWS）就是透過病人的生命徵象及臨床症狀之些微變化，來偵測病情可能出現惡化的一種預測方式（Smith et al., 2014）。絕大多數的病人在心跳停止前會出現生理徵兆的變化，而運用一個完善的EWS可早期識別出病人可能出現非預期的心跳停止或死亡等嚴重不良事件（serious adverse events），進而減少病人面臨非預期風險（Gerry et al., 2017）。另一方面，對於醫護團隊人員而言，EWS的運用不僅能早期發現病人的病情變化，讓相關人員做出積極的反應，並且能改善醫護團隊間的溝通、提升團隊間的合作及增強健康照護者的個人責任感（Burns et al., 2018）。總而言之，使用EWS可及時給予病人適當的治療，這對病人的照護結果來說是一個正面的影響，不論是在臨床或居家機構，將EWS融入病人照顧的處置中，是守護病人生命極為重要的策略，但仍需依不同疾病特性來設計適當的標準化警示系統。在病人發生病情變化時，傳統上的做法是先由護理人員評估其病情，再由護理人員決定是否通知醫師處理，但這個過程中有可能受到評估的正確性、文化差異性、自信心和過去經驗的影響而產生人為錯誤（Wood, Chaboyer, & Carr, 2019），而警示系統與資訊科技結合的進階發展，將可減少人為判讀出現之遺漏與錯誤（Downey, Tahir, Randell, Brown, & Jayne, 2017），雖然使用醫學資訊技術增強預警系統仍處於起步階段，但這必將是未來病人照護上的趨勢之一。在本期專欄中，除了簡介EWS的運用之外，也說明目前EWS在臨床重症狀況下的應用，以及結合資訊科技於居家EWS中的介紹，這些專欄文章充分討論了EWS，可提供臨床護理、居家照護、教學以及研究上之參考。.