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Sri Haryuni
Universitas Kadiri
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Journal : Journal Of Nursing Practice

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Integrating the Early Warning Scoring System (EWSS) into Nursing Students’ Assessment to Enhance Critical Thinking and Optimize Patient Care in Inpatient Settings Lutfi, Erik Irham; Suharto, Idola Perdana Sulistyoning; Haryuni, Sri; Fitriasnani, Meirna Eka; Wahdi, Achmad
Journal Of Nursing Practice Vol. 9 No. 3 (2026): April
Publisher : Universitas STRADA Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30994/jnp.v9i3.1039

Abstract

Background: High-quality nursing care begins with an accurate and comprehensive patient assessment. The Early Warning Scoring System (EWSS) is a vital tool in inpatient units for monitoring vital signs and detecting early signs of clinical deterioration, enabling timely intervention. However, field observations indicate that nursing students often lack a practical understanding and the ability to apply EWSS, leading to passivity and uncertainty in clinical decision-making. Therefore, the development of EWSS-based initial assessments within nursing care reports is essential to enhance students' critical thinking and rational intelligence in clinical practice.Purpose: This study aims to develop and implement an EWSS-based initial assessment model that enables students to integrate assessment findings, scoring values, and appropriate clinical interventions. Through the interpretation of EWSS scores, students are expected to improve their clinical reasoning and decision-making skills within inpatient nursing services.Methods: This study employed a comparative analytical quantitative design. The research was conducted in the inpatient wards of a hospital in East Java. The population consisted of all nursing profession students (Ners) undergoing clinical practice in 2024, with a total sample size of 28 respondents. The independent variable was the nursing care report integrated with EWSS indicators, while the dependent variable was the students' rational intelligence in clinical decision-making related to EWSS outcomes. Data were collected using initial assessment observation sheets supplemented with EWSS. Statistical analysis was performed using the Wilcoxon test to determine differences before and after the intervention.Results: The integration of EWSS parameters into nursing students' assessment instruments significantly improved their ability to accurately interpret patients' clinical conditions and guided them in determining interventions, thereby enhancing rational intelligence. Conclusion: Early exposure to EWSS among students ultimately supports the creation of safer (patient safety) and more effective nursing care across all clinical practice settings.
Co-Authors Abda Abda Abdurahman Wahid Achmad Wahdi Adhitia Rosyadi, Firdaus Alimansur, Moh Alves, Remigio Halek An Nisa Sukmawati, Datin Ardiyani, Vita Maryah Arif Nurma Etika Astuti, Dita Apriana Dwi Ayuningtyas, Rahayu Bin Abd Kadir, Mujtahid Christine Dupe Datin An Nisa Sukmawati Dedi Sahputra Napitupulu, Dedi Sahputra Dessy Lutfiasari Dina Septiany Ediatmi Ediatmi Eko Winarti Erik Irham Lutfi Evi Purwanti Fachry Abda El Rahman Fahma Laili, Nur Fatma Sayekti Ruffaida Fatma Sayekti Ruffaida Fatma Sayekti Ruffaida, Fatma Sayekti Fery Yuniarto, Prayoga Fitriasnani, Meirna Eka Handayani , Wiwik Hawiyah, Siti Idola Perdana Sulistyoning Suharto Ifana Anugraheni Im, Supriadi Indah Jayani Indah Jayani Joko Purwanto Karingga, Devangga Darma Kun Ika Nur Rahayu Kun Ika Nur Rahayu Kun Ika Nur Rahayu Lisna Watie Geragam Martenci Ledoh, Nurani Maulana, Irvan Mei Fita Asri Untari Mirasa, Yudied Agung Mujtahid Bin Abd. Kadir Mursal Aziz Neni Probosiwi Novita Agnes, Yeni Lufiana Novita Agnes, Yeni Lutfiana Novita Ana Anggraini Novita Ana Anggraini Nur Fahma Laili NUR KHOLIFAH Nur Rahayu, Kun Ika Nurma Afiani Oresye, Berta Perdana Sulistyoning Suharto, Idola prayoga fery yuniarto Rauf, Fitrah Hi Retty Ratnawati Retty Ratnawati Rias, Natan Rindang Fitriana Ulfa Rinik Eko Kapti Rinik Eko Kapti, Rinik Samelina Eleeuw Samudera, Wahyu Sukma Seno Andri Sri Widati Sukmo, Previ Kuncoro Sulistya, Wiwin Sulistyawati, Wiwin Sulistyawati, Wiwin Sulistyoning Suharto, Idola Perdana Sulistyoning Suharto, Idola Perdana Sunardi Sunardi Sunardi Sutriningsih, Ani Tsamrotul Ilmi Wahid, Abdurahman Wahyu Dini Metrikayanto, Wahyu Dini Wahyu Sukma Samudera winarti, eko Wiwin Sulistya Wiwin Sulistyawati Wulandari, Riny Prasasty Yeni L. N. A Yeni L. N. Agnes Yoga Yuniadi Yohanes Tatan Yunalia, Endang Mei Yusuf, Anita