Aim: The aim of this study was to explore hospital nurses' perceptions and reactions to the National Early Warning Score during an introduction programme.

Design: A qualitative case study approach with participatory observations was used for this study.

Methods: In total, nine seminars and 23 simulation sessions attended by nurses were observed. An activity theory system analysis was applied to interpret the material.

Results: The findings revealed four tensions related to the working context: (a) tension between using a standardized tool and relying on clinical judgement (the tool could be either an aid or a barrier to patient assessment); (b) tension in the community of practice (the tool could be beneficial or increase stress and anxiety); (c) tension related to rules and compliance (the tool could be perceived as optional or compulsory); and (d) tension related to the division of labour (nurses feared more work).

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6650757PMC
http://dx.doi.org/10.1002/nop2.291DOI Listing

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