Table 3

Six principal themes

Theme	Description
Timeliness	Nurses were often aware of the patient’s decline and began or completed the appropriate intervention before the EWS triggers and the VCT calls.
Workflow Interruption	Nurses were often called about an EWS alert while they were busy implementing the appropriate medical interventions.
Accuracy	Nurses perceived the EWS algorithm to be inaccurate, citing many anecdotes of false positives and false negatives, especially with the EWS’s inclusion of subjective nursing assessment data, such as urine colour and patient mood.
Actionability	Nurses felt the VCT rarely offered actionable, novel suggestions, however, some nurses appreciated the EWS and VCT as a safety net.
Underappreciation of core nursing skills	Nurses emphasised the value of in-person assessments and were concerned with the reliance on technology by a hands-on profession.
Opportunity cost	Nurses cited the need for additional hands-on support and criticised spending on the EWS during a time of hospital financial stress.