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27.07.12

NEWS system to provide a ‘step-change’ in patient safety

The Royal College of Physicians (RCP) has launched a new National Early Warning Score (NEWS), to recognise very sick patients 

A report on NEWS was produced by a multidisciplinary working group and clinical observation charts and e-learning materials have been provided by the NEWS educational programme, funded by the RCP, Royal College of Nurses (RCN), National Outreach Forum and NHS Training for Innovation.

On each acute hospital bed, a chart records patients’ pulse rate, blood pressure and temperature, but different NHS trusts use different types of chart, leading to a lack of consistency in the detection and response to acutely ill patients.

The NEWS system allocates a score to six physiological measurements; respiratory rate, oxygen saturations, temperature, systolic blood pressure, pulse rate and level of consciousness.

The more measurements vary from what would be expected, the higher the resultant score. These six scores are then aggregated into one overall score which, if high, will alert the medical or nursing team of the need to escalate a patient’s care.

RCP believes this provides the basis for a unified approach to assessment and continuous tracking of patients’ clinical care, standardised training of all staff and standardised data on regional variations in illness severity.

NEWS also provides detailed recommendations on actions for each score, and the e-learning materials aim to help trusts with implementation. NEWS has been evaluated against existing systems and proved to be as good as, or better, with greater sensitivity when triggering alerts.

A recent study of 1,000 adults dying in acute hospitals inEnglandestimated that around one in 20 deaths in hospital, or 11,859, were preventable by improved clinical monitoring, fewer diagnostic errors and good drug or fluid management. Professor Bryan Williams, chair of the working party, estimated that around 50% of these deaths, 6,000, could have been prevented by using NEWS.

He said: “This new National Early Warning Score has the potential to transform patient safety in our hospitals and improve patient outcomes, it is hugely important.”

Professor Derek Bell, chair of the NEWS educational subgroup, said adopting NEWS would be “one of the most significant developments in health care in the next decade”.

And RCN director of nursing and service delivery, Janet Davies said: “There is nothing nurses and doctors should prioritise more than patient safety, and this system, if implemented across the board, will be a great leap forward for patient care. 

“I hope that every Trust will read this report and adopt this system as soon as possible, as countless lives could be saved in the future by adopting this simple process.”

www.rcplondon.ac.uk/sites/default/files/documents/national-early-warning-score-standardising-assessment-acute-illness-severity-nhs.pdf

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