Distribution of the National Early Warning Score (NEWS) in care home residents

Barker, Robert; Stocker, Rachel; Russell, Siân; Roberts, Anthony; Kingston, Andrew; Adamson, Joy; Hanratty, Barbara

doi:10.1093/ageing/afz130

Cited by 24 publications

(45 citation statements)

References 6 publications

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“…Depending on the injury mechanism, an initial systematized assessment and a few additional tests are used to decide, in line with treatment guides, the best treatment strategy for this specific situation. The early warning scores (EWS) are tools that can help the professional to make clinical decisions, predict the risk of deterioration, monitor the evolution of the patient, and facilitate communication between different levels of care, specifically to promote the safety of the patient [11,12].…”

Section: Introductionmentioning

confidence: 99%

Identification of Serious Adverse Events in Patients with Traumatic Brain Injuries, from Prehospital Care to Intensive-Care Unit, Using Early Warning Scores

Martin-Rodríguez

López-Izquierdo

Mohedano-Moriano

et al. 2020

IJERPH

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Traumatic brain injuries are complex situations in which the emergency medical services must quickly determine the risk of deterioration using minimal diagnostic methods. The aim of this study is to analyze whether the use of early warning scores can help with decision-making in these dynamic situations by determining the patients who need the intensive care unit. A prospective, multicentric cohort study without intervention was carried out on traumatic brain injury patients aged over 18 given advanced life support and taken to the hospital. Our study included a total of 209 cases. The total number of intensive-care unit admissions was 50 cases (23.9%). Of the scores analyzed, the National Early Warning Score2 was the best result presented with an area under the curve of 0.888 (0.81–0.94; p < 0.001) and an odds ratio of 25.4 (95% confidence interval (CI):11.2–57.5). The use of early warning scores (and specifically National Early Warning Score2) can help the emergency medical services to differentiate traumatic brain injury patients with a high risk of deterioration. The emergency medical services should use the early warning scores routinely in all cases for the early detection of high-risk situations.

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Section: Introductionmentioning

confidence: 99%

Identification of Serious Adverse Events in Patients with Traumatic Brain Injuries, from Prehospital Care to Intensive-Care Unit, Using Early Warning Scores

Martin-Rodríguez

López-Izquierdo

Mohedano-Moriano

et al. 2020

IJERPH

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“…The use of early warning scores (EWS) is a reality in the current clinical practice [3] and has become a standard procedure in many contexts and pathologies [4,5]. Among all scores, the National Early Warning Score 2 (NEWS2) [6] has proven to be useful in the prehospital context, is validated, and commonly used internationally [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Prehospital Point-Of-Care Lactate Increases the Prognostic Accuracy of National Early Warning Score 2 for Early Risk Stratification of Mortality: Results of a Multicenter, Observational Study

Martin-Rodríguez

López-Izquierdo

Benito³

et al. 2020

JCM

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The objective of this study was to assess whether the use of prehospital lactate (pLA) can increase the prognostic accuracy of the National Early Warning Score 2 (NEWS2) to detect the risk of death within 48 h. A prospective, multicenter study in adults treated consecutively by the emergency medical services (EMS) included six advanced life support (ALS) services and five hospitals. Patients were assigned to one of four groups according to their risk of mortality (low, low-medium, medium, and high), as determined by the NEWS2 score. For each group, the validity of pLA in our cohort was assessed by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. In this study, 3081 participants with a median age of 69 years (Interquartile range (IQR): 54–81) were included. The two-day mortality was 4.4% (137 cases). The scale derived from the implementation of the pLA improved the capacity of the NEWS2 to discriminate low risk of mortality, with an AUC of 0.910 (95% CI: 0.87–0.94; p < 0.001). The risk stratification provided by the NEWS2 can be improved by incorporating pLA measurement to more accurately predict the risk of mortality in patients with low risk.

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“…Qualitative interviews were conducted with stakeholders in addition to quantitative analysis of NEWS recordings from the 47 care homes over 24 months, published elsewhere, 19 and a survey sent to care homes in the area (see Supplementary Table S1; Responses to the NoMAD survey instrument, and Supplementary Box S1; Survey instrument, for details).…”

Section: Methodsmentioning

confidence: 99%

“…17,18 Data were published in 2019 on expected values of NEWS in care home residents. 19 This article outlines the findings from the qualitative component of an evaluation of an…”

Section: The Interventionmentioning

confidence: 99%

Implementation of the National Early Warning Score in UK care homes: a qualitative evaluation

et al. 2020

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BackgroundThe National Early Warning Score (NEWS) is a tool for identifying and responding to acute illness. When used in care homes, staff measure residents’ vital signs and record them on a tablet computer, which calculates a NEWS to share with health services. This article outlines an evaluation of NEWS implementation in care homes across one clinical commissioning group area in northern England.AimTo identify challenges to implementation of NEWS in care homes.Design and settingQualitative analysis of interviews conducted with 15 staff members from six care homes, five health professionals, and one clinical commissioning group employee.MethodInterviews were intended to capture people’s attitudes and experiences of using the intervention. Following an inductive thematic analysis, data were considered deductively against normalisation process theory constructs to identify the challenges and successes of implementing NEWS in care homes.ResultsCare home staff and other stakeholders acknowledged that NEWS could enhance the response to acute illness, improve communication with the NHS, and increase the confidence of care home staff. However, the implementation did not account for the complexity of either the intervention or the care home setting. Challenges to engagement included competing priorities, insufficient training, and shortcomings in communication.ConclusionThis evaluation highlights the need to involve care home staff and the primary care services that support them when developing and implementing interventions in care homes. The appropriateness and value of NEWS in non-acute settings requires ongoing monitoring.

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Distribution of the National Early Warning Score (NEWS) in care home residents

Cited by 24 publications

References 6 publications

Identification of Serious Adverse Events in Patients with Traumatic Brain Injuries, from Prehospital Care to Intensive-Care Unit, Using Early Warning Scores

Identification of Serious Adverse Events in Patients with Traumatic Brain Injuries, from Prehospital Care to Intensive-Care Unit, Using Early Warning Scores

Prehospital Point-Of-Care Lactate Increases the Prognostic Accuracy of National Early Warning Score 2 for Early Risk Stratification of Mortality: Results of a Multicenter, Observational Study

Implementation of the National Early Warning Score in UK care homes: a qualitative evaluation

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