Use of scoring tools in municipal in-patient acute care services – a cross-sectional study

Method: Cross-sectional study with a questionnaire distributed to 220 first-line managers in all of Norway' s MIPAC units.Results: A total of 207 first-line managers 91.6 per cent) were included in the study.Some 57 per cent of the units examined used the Early Warning Score EWS systematically to identify deteriorating somatic condition at an early stage while 29 per cent of the units did not use this.The sepsis scoring tool recommended when the data were collected was systematically used in 46 per cent of the units, while 32 per cent did not use a sepsis score.The use of these tools was lowest in units in Central and Northern Norway and in MIPAC services co-located with long-stay care units.The scoring tool for identifying fall risk was systematically used in 45 per cent of the units, and the nutritional risk screening tool in 55 per cent of the units, while 34 per cent and 33 per cent respectively did not use the tools.Having a professional development nurse (often referred to in the literature as ' clinical nurse educator' ) attached to the unit was the most important factor in the use of the Early Warning Score and tools to assess nutritional status. Conclusion:The study reveals that there is a considerable potential for increased use of scoring tools in MIPAC services in Norway.The results indicate that this can be achieved by strengthening clinical management through employing professional development nurses in the units.