Modified Early Warning Scores (MEWS) are now commonly used for the assessment of unwell patients in general hospitals. It can be used to quickly identify the deteriorating patients who need urgent intervention. The use of MEWS has been shown to be effective in reducing mortality and morbidity of patients who deteriorate slowly. Its use in mental health has not been thoroughly studied.

Standard MEWS form was reproduced and customized for using in psychiatric wards. A survey was conducted on level of confidence of Chiltern unit's nursing staff before and after introducing the MEWS form.

They were asked to make a decision about management of two standard case studies and rate their level of self confidence from 1 to 5 before and after using the form.

10 nursing staff band 5 and 6 took part in this study with wide range of experience from 6 months to 20 years (Average 9.7 years).

The average level of confidence before introducing MEWS was 3.65± 0.66 and rose to 4.6±0.5 afterward. The improvement in the level of confidence was statistically significant (P = 0.002).

The validity of decisions made by nursing staff about two cases rose from 45% before using the form to 100% afterward. The improvement in the validity of decision making after introduction of MEWS system was also statistically significant (P< 0.0001).

Our study suggests promising potentials for improvement in patients’ safety and confidence of nursing staff by introducing MEWS system to in-patient psychiatric wards.