New Zealand national maternity early warning system (MEWS) preparation and implementation guide

1 Mar 2019 | Patient Deterioration

The health of pregnant and recently pregnant women can deteriorate for many reasons. At times, the failure to recognise signs of deterioration, escalate care and respond appropriately can cause preventable deterioration. We encourage maternity services and the wider hospital to establish a system for managing the care of pregnant, and recently pregnant (up to and including 42 days later), women who deteriorate while receiving in-hospital care.

This guide helps project leads and teams prepare for and implement a nationally consistent maternity early warning system (MEWS). It sets out the aim of the national MEWS programme, components to implement, available support, and recommended activities during the prepare, implement and sustain periods.

Specific tools and guidance have been developed to help you prepare for and implement the clinical, local measurement, and governance components of the MEWS. These are available to download below.

If you have any queries about these resources, please email

Preparation and implementation guide
Preparation and implementation guide (2MB, PDF)
Recognition: supporting tools and guidance
Maternity vital signs chart – editable PDF (1.2MB, PDF)
Maternity vital signs chart user guide (1.2MB, PDF)
Escalation and response sticker to aid clinical documentation (95KB, DOCX)
Escalation mapping tool (383KB, DOCX)
Factsheet – the eight vital signs (279KB, PDF)
Response: supporting tools and guidance
Factsheet for project teams – capabilities (387KB, PDF)
Factsheet for clinicians – sepsis (363KB, PDF)
Factsheet for clinicians – hypertension (298KB, PDF)
Factsheet for clinicians – supplemental oxygen (322KB, PDF)
Factsheet for clinicians – clinical communication tools (297KB, PDF)
Clinical governance: supporting tools and guidance
Clinical governance recommendations (246KB, PDF)
Example policy (220KB, PDF)
Education: supporting tools and guidance
Factsheet for senior clinicians and clinical leads (298KB, PDF)
Factsheet for midwives (322KB, PDF)
Factsheet for nurses (318KB, PDF)
Factsheet for clinicians – FAQs (321KB, PDF)
Education PowerPoint (8.6MB, PPTX)
Educational poster (733KB, PDF)
MEWS virtual grand round presentation

Instructions for completing maternity vital signs chart and MEWS eLearning via LearnOnline

  1. Access the Ministry of Health’s LearnOnline platform at:  
  2. You will need to enable pop ups if it asks you.
  3. Click on course catalogue.
  4. Search MEWS.
  5. Click on the icon: Maternity vital signs chart & EWS.
  6. Click on enrol.
  7. Click log in (after guests cannot access this course).
  8. Click on create a new account (if you don’t already have one) .
  9. If you have issues logging in, please use the ‘contact support’ link on the LearnOnline homepage.
  10. Any queries contact
Measurement: supporting tools and guidance
Measurement guidance (254KB, PDF)
Audit form (46KB, DOCX)
Case review updated August 2021 – editable MS Word version (120KB, DOCX) or PDF version (171KB, PDF) 
Weekly data collection tool (548KB, XLSM)
Monthly data collection tool (824KB, XLSM)

The following additional materials are available on request by emailing

  • project charter template
  • current system assessment template
  • stakeholder assessment template
  • countdown to launch posters
  • eLearning module.

Last updated 25/10/2021