National early warning score 2 (NEWS 2) – the latest version of NEWS – will be implemented in NHS Lanarkshire week beginning Monday 19 August and will go live on Patient Track on Tuesday 20 August. This will require a short 15-minute downtime on Patient Track at 11am to facilitate the changeover.
The implementation of NEWS 2 will align to the recommendations within SIGN167 (2023) – care of the deteriorating patient. The national guideline advocates the management of the deteriorating adult patient with a suspicion of sepsis within the emergency department and hospital setting should be based on the national early warning score 2 (NEWS 2).
NEWS 2 is based on a simple aggregate scoring system in which a score is allocated to physiological measurements. Six simple physiological parameters form the basis of the scoring system:
1. respiration rate;
2. oxygen saturation;
3. systolic blood pressure;
4. pulse rate;
5. level of consciousness or new confusion;
6. temperature.
The key changes when using NEWS 2 will be:
o The chart will be laid out in a familiar ABCDE format to allow comprehensive patient assessment;
o Air or oxygen – if the patient is receiving oxygen, the percentage of oxygen must be recorded along with the delivery device, for example nasal cannulae, venturi mask, trauma mask or nasal high flow;
o Consciousness – this now incorporates any new confusion or delirium. Patients with chronic confusion should score 0.
Change to NEWS 0 escalation plan
o Refer to observation policy for first 48 hours of admission;
o Inpatients require a minimum 12-hourly observations unless stopped or amended by a senior decision maker. This should be recorded in the record of care.
Clinical staff should complete the TURAS NEWS 2 e-learning module via the link below. Please log into your TURAS learn account to access the module. Please note that staff are advised to have a NEWS 2 chart available while completing this as practical examples are provided.
https://learn.nes.nhs.scot/1010/patient-safety-zone/news2-national-early-warning-score-e-module
For further reading, please visit:
- https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2
- https://www.sign.ac.uk/our-guidelines/care-of-deteriorating-patients/
