The Irish Maternity Early Warning System (IMEWS)

In the acute hospital setting, the use of early warning scores (EWS) to monitor vital signs (including heart rate, respiratory rate [RR], blood pressure and temperature) has been shown to be beneficial in the early diagnosis and prompt initiation of treatment in adults with a critical illness. This led to the development of the National Early Warning Score (NEWS) in Ireland by the Health Services Executive’s (HSE) Acute Medicine Clinical Care Programme. The NEWS was the first guideline endorsed by the National Clinical Effectiveness Committee (NCEC) and was launched by the Minister of Health Dr James Reilly in 2013. The implementation of NEWS is now mandatory in all acute hospitals. However, NEWS is not suitable for use in pregnancy because a woman's vital signs change physiologically from early in pregnancy. National reports in Ireland and the United Kingdom (UK) on maternal mortality have led to recommendations that a modified obstetric EWS be introduced. In Ireland, these recommendations have been further supported by separate investigations in 2008 and 2013 on two maternal deaths from sepsis.