What is the NEWS scale, where and how is it used and what are it’s limitations? Laura Pueyo explains in detail how it plays a supporting role in assessing patient health.
Hey guys!
My name is Laura, I am one of the nurses from the NHS.
Today I would like to talk about the National Early Warning Score or NEWS scale, which is a critical tool used by Healthcare Professionals to assess the clinical status of patients and detect early warning signs of deterioration. This scale is a key element of patient safety and improving patient outcomes.
So, what does the NEWS scale tell us exactly and how do we use that scale?
The NEWS scale was developed by the Royal College of Physicians with the objective of creating a standardised and consistent approach to patient observation. The goal was to identify early warning signs of deterioration and prioritise patients who are in need of urgent medical intervention to ensure that appropriate care is provided in a timely manner. They build it gathering clinical information from 2005 to 2012 about several patients and from there built the scale. After that the NEWS scale was updated in 2017 to the NEWS 2, which is the current version used in the NHS.
How Does It Work?
The NEWS scale assigns a score to a patient based on six physiological parameters, including:
• respiration rate,
• oxygen saturation,
• blood pressure,
• heart rate,
• level of consciousness,
• and temperature.
The score is calculated through a 0-to-3-point system for each parameter, and two additional points are added if the patient is receiving oxygen therapy. The overall score ranges from 0 (indicating no signs of deterioration) to 20 (indicating severe deterioration), and healthcare professionals use the score to evaluate the risk of deterioration. So, what we try for those with scores between 0 and 20, is early action to reduce the probability of the patients reaching the 20 points score.
Respiration Rate Is Key
I’d like to remark that the first parameter is the respiration rate which is one of the “forgotten” parameters. The RR is considered a vital sign, and changes in its rate can provide important information about the patient's condition.
An elevated respiration rate, also known as tachypnea, can be a sign of respiratory distress, and could indicate the presence of conditions such as pneumonia, asthma, or heart failure. On the other hand, a decreased respiration rate, also known as bradypnea, can be a sign of central nervous system depression, which could be indicative of conditions such as overdose or head injury.
In the NEWS scale, the respiration rate is assigned a score based on its value. A higher score indicates a more severe illness and a greater need for intervention. For example, an RR of 12-20 breaths per minute would score 0 point, while an RR of > 25 breaths per minute would score 3 points.
In conclusion, the respiration rate is an important component of the NEWS scale and plays a crucial role in the assessment of patients.
About this contributor
Band 7 NHS Nurse
I am a dedicated nurse with 10 years of experience in the healthcare field, having worked both in the UK and Spain. I have spent several years as a Band 7 nurse in the NHS, where I developed advanced clinical and leadership skills. In addition to my nursing experience, I hold a Master's degree in Healthcare Management.
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Abby Jonah
one year agoMy understanding is that it is recommended to repeat the vital signs of a patient with a NEWS of 5 ... read more
My understanding is that it is recommended to repeat the vital signs of a patient with a NEWS of 5 to 6 hourly until the patient is reviewed and a plan is put in place.
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In general, the frequency with which vital signs should be repeated in a patient with a NEWS score of 5 will depend on a variety of factors, including the patient's underlying condition, the severity ... read more
In general, the frequency with which vital signs should be repeated in a patient with a NEWS score of 5 will depend on a variety of factors, including the patient's underlying condition, the severity of their symptoms, and the presence of any additional risk factors or comorbidities. However, as a general guideline, patients with a NEWS score of 5 typically require close monitoring and more frequent assessment of their vital signs than patients with lower scores. The exact frequency of monitoring will be determined by the healthcare professional based on their clinical judgment and the specific needs of the patient. In many cases, vital signs may need to be repeated every 4-6 hours or more frequently, especially if the patient's condition is unstable or if there are concerns about their clinical status. More frequent monitoring may be necessary if the patient's symptoms worsen or if there are other changes in their clinical status. It is important to note that the frequency of monitoring may change over time as the patient's condition evolves, and healthcare professionals will adjust their assessment and monitoring plan as needed to ensure that the patient receives the appropriate level of care.
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