NEWS 2 Tool

Question 1

What does the Nursing and Midwifery Council Code (NMC, 2018) require from nurses and midwives?

Answer 1

Accurately identify signs of worsening physical health in the person receiving care.

Question 2

What can compromise the safety of patients according to Grant & Crimmons (2018)?

Answer 2

Variations in practice and assessment.

Question 3

How can early warning scores assist healthcare professionals?

Answer 3

Help appropriately respond to a patient’s condition and escalate to the medical team if indicated.

Question 4

What is the estimated number of lives that could be saved annually in hospitals in England through standardized assessment tools?

Answer 4

1800 lives.

Question 5

What monitoring system did NICE recommend for adult patients in acute hospital settings in 2007?

Answer 5

‘Track-and-trigger’ monitoring systems.

Question 6

What is the purpose of the National Early Warning Score (NEWS)?

Answer 6

Standardise assessment of, and response to, acute illness in those over 16 years old.

Question 7

What are the key improvements in the NEWS2 update from 2017?

Answer 7

• Restructured physical measurements to align with ABCDE assessment
• Improved identification of patients likely to have sepsis
• Improved scoring for patients with hypercapnic respiratory failure
• Recognition of new-onset confusion or delirium.

Question 8

What does the RCP published supplementary guidance for NEWS2 focus on?

Answer 8

• Assessment of new confusion
• Monitoring frequency for elevated NEWS2 scores
• Use of appropriate oxygen scale
• Use of NEWS2 scores during patient transfers
• Actions for incomplete NEWS2 measurements.

Question 9

In which patients is NEWS2 not used?

Answer 9

Patients with spinal cord injury and pregnant patients.

Question 10

What is being developed for patients under 16 years old in relation to early warning systems?

Answer 10

A national paediatric early warning system scoring tool.

Question 11

What has been reported since the introduction of NEWS?

Answer 11

• Reduced length of hospital stays
• Reduction in mortality from sepsis and acute illness
• Reduction in cardiac arrest rates.

Question 12

What are the advantages of digital NEWS systems over paper-based charts?

Answer 12

• Minimise human error
• Save time taken to complete observations by 30%.

Question 13

Is NEWS2 a replacement for clinical judgement?

Answer 13

No, it is an assessment aid and does not replace experienced clinical judgement.

Question 14

What physiological measurements are taken for the NEWS2 assessment?

Answer 14

• Temperature
• Level of consciousness and new confusion
• Pulse rate
• Systolic blood pressure
• Oxygen saturation (SpO2)
• Respiration rate.

Question 15

What is an important exclusion in the NEWS2 assessment?

Answer 15

Urine output.

Question 16

What is the scoring system based on for the NEWS2 chart?

Answer 16

An alert colour-coding system where:
* White range = 0
* Yellow range = 1
* Orange range = 2
* Red range = 3.

Question 17

What should be done if no decision has been made about which SpO2 scale to use?

Answer 17

Always choose scale 1 as the default and record this decision in the patient’s notes.

Question 18

What do high scores in NEWS2 indicate?

Answer 18

Potential deterioration in a patient’s condition.

Question 19

Fill in the blank: The NEWS2 assessment aims to help detect deterioration in adults by triggering _______.

Answer 19

[review, treatment and escalation of care where appropriate].

Question 20

True or False: The NEWS2 chart uses a single oxygen saturation scoring scale.

Answer 20

False.

Question 21

What does the NEWS2 chart record after each measurement?

Answer 21

Record it immediately on the NEWS2 chart.

Question 22

What should you do if the respiratory rate falls within a red box?

Answer 22

Record the number of breaths per minute within this box.

Question 23

What is the target oxygen saturation range for patients in hypercapnic respiratory failure?

Answer 23

88-92%

Question 24

What does the systolic blood pressure score use?

Answer 24

Only the systolic BP.

Question 25

What does a score of 3 indicate for systolic blood pressure?

Answer 25

≥220 mmHg

Question 26

How should the patient's oxygen saturation be recorded?

Answer 26

Mark the corresponding box using a dot or record the value in the inset.

Question 27

What is the ACVPU scale used for?

Answer 27

To assess the patient's level of consciousness.

Question 28

What does the 'A' in the ACVPU scale stand for?

Answer 28

Alert: Spontaneous opening of eyes, responds to voice and has motor function.

Question 29

What is indicated by a new onset of confusion in a patient?

Answer 29

Potentially serious clinical deterioration.

Question 30

What is the scoring for a temperature above 39.1°C?

Answer 30

Score of 2.

Question 31

Fill in the blank: The NEWS2 scoring system uses _______ to assess respiratory rate.

Answer 31

breaths per minute.

Question 32

True or False: The diastolic blood pressure recording affects the NEWS2 score.

Answer 32

False

Question 33

What should be documented if an observation cannot be obtained?

Answer 33

Document the score but mark it as incomplete.

Question 34

What is the significance of peripheral temperature assessment?

Answer 34

Cold and clammy extremities may indicate hypoperfusion.

Question 35

What does a score of 0 on the NEWS2 indicate?

Answer 35

No clinical deterioration.

Question 36

What is the purpose of early warning system technologies in the context of NEWS2?

Answer 36

To automatically capture vital signs and calculate the NEWS score.

Question 37

What does the 'P' in the ACVPU scale stand for?

Answer 37

Pain: The patient responds only to a painful stimulus.

Question 38

What should be done if the equipment fails to record an observation?

Answer 38

Trigger an immediate response and take the parameter manually.

Question 39

What does a score of 1 for pulse rate indicate?

Answer 39

101-110 beats/min.

Question 40

What is the lowest temperature range that can be recorded on the NEWS2 chart?

Answer 40

c35.0°C

Question 41

What does a systolic blood pressure of ≥220 mmHg score on the NEWS2 chart?

Answer 41

3

Question 42

What is the score for a pulse rate of 91-100 beats per minute?

Answer 42

1

Question 43

Fill in the blank: A temperature of ≥39.1°C scores _____ on the NEWS2 chart.

Answer 43

3

Question 44

What is the scoring for oxygen saturation of 92-93% on SpO2 Scale 1?

Answer 44

2

Question 45

True or False: A NEWS2 score of zero is equivalent to normal values.

Answer 45

False

Question 46

What does a NEWS2 score of 5 or more indicate?

Answer 46

Urgent response threshold

Question 47

What is the minimum monitoring frequency for a NEWS2 score total of 1–4?

Answer 47

4–6 hourly

Question 48

What should be considered if a patient with a NEWS2 score of 5 or more shows signs of infection?

Answer 48

Immediate escalation of care

Question 49

What does the NEWS2 scoring system assess?

Answer 49

Respirations, SpO2, blood pressure, pulse, consciousness, temperature

Question 50

Fill in the blank: A pulse rate of ≥131 beats per minute scores _____ on the NEWS2 chart.

Answer 50

3

Question 51

What is the significance of new-onset confusion in a patient?

Answer 51

Potentially serious clinical deterioration

Question 52

What should be done if a patient scores below the lowest SpO2 value on scale 1 or scale 2?

Answer 52

Document and assess individual threshold daily

Question 53

What is the response for a NEWS2 score total of 7 or more?

Answer 53

Emergency response threshold

Question 54

What is the target oxygen saturation range for patients with hypercapnic respiratory failure?

Answer 54

88-92%

Question 55

What is the first step in calculating the NEWS2 score?

Answer 55

Take a full set of physical measurements

Question 56

What must be recorded in the 'NEWS TOTAL' box?

Answer 56

The sum of individual scores

Question 57

What does a score of 3 in a single parameter trigger?

Answer 57

An urgent response

Question 58

Fill in the blank: A respiratory rate of 18-20 breaths per minute scores _____ on the NEWS2 chart.

Answer 58

0

Question 59

What should be monitored more frequently than recommended according to NEWS2?

Answer 59

Patients critically unwell or at risk of sudden deterioration

Question 60

What is the target oxygen saturation range for Donald?

Answer 60

88–92 per cent ## Footnote This range is important for managing his respiratory condition.

Question 61

What physiological measurement scale must be used for Donald's SpO2?

Answer 61

SpO2 scale 2 ## Footnote This scale is specifically indicated for his condition.

Question 62

What condition has been confirmed for Donald through arterial blood gas analysis?

Answer 62

Hypercapnia ## Footnote Hypercapnia indicates a high level of carbon dioxide.

Question 63

What was Donald's last NEWS2 score recorded?

Answer 63

4 ## Footnote This score indicates a need for a ward-based response.

Question 64

How often should Donald's physiological measurements and NEWS2 score be monitored?

Answer 64

Every 4 hours ## Footnote Regular monitoring is essential for assessing his condition.

Question 65

What does a NEWS2 score of 4 indicate?

Answer 65

Requires a ward-based response ## Footnote This score suggests that the patient is at risk and needs further observation.

Question 66

What can be inferred about Donald's response to treatment?

Answer 66

He has responded well to treatment ## Footnote This response likely includes all interventions, not just oxygen.

Question 67

What is the significance of the National Early Warning Score 2 (NEWS2)?

Answer 67

It is used to assess the clinical status of patients and determine the level of care needed. ## Footnote Developed by the Royal College of Physicians in 2017.

Question 68

In the NEWS2 scoring system, how is the blood pressure measured?

Answer 68

Using systolic BP only ## Footnote This method focuses on the upper number of blood pressure readings.

Question 69

What is the minimum pulse rate that would score a 1 in the NEWS2 system?

Answer 69

41-50 beats/min ## Footnote This scoring is part of the assessment for vital signs.

Question 70

Fill in the blank: The NEWS2 score uses __________ for assessing consciousness.

Answer 70

Alertness and new onset of confusion ## Footnote This helps determine cognitive status.

Question 71

True or False: A patient with a temperature of 38.1-39.0°C scores a 2 in the NEWS2 system.

Answer 71

True ## Footnote This temperature range indicates a moderate fever.

Question 72

What is Donald's full name and date of birth?

Answer 72

Donald Russell, 20/3/1955 ## Footnote Personal information is crucial for patient identification.

Question 73

What does a SpO2 reading below 88% indicate for Donald?

Answer 73

Potential respiratory failure ## Footnote This is critical for decision-making regarding interventions.

Question 74

What is the NEWS total score recorded for Donald?

Answer 74

4 ## Footnote This total is important for evaluating ongoing risk.